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Case Reports in Infectious Diseases
Volume 2016, Article ID 8280915, 4 pages
http://dx.doi.org/10.1155/2016/8280915
Case Report

Cryptococcus gattii in an Immunocompetent Patient in the Southeastern United States

1Department of Neurosurgery, University of Alabama at Birmingham, School of Medicine, Birmingham, AL, USA
2School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
3Department of Veterans Affairs, Veterans Affairs Medical Center, Birmingham, AL, USA

Received 11 August 2016; Accepted 26 October 2016

Academic Editor: Paola Di Carlo

Copyright © 2016 John W. Amburgy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Cryptococcal infections are seen throughout the United States in both immunocompromised and immunocompetent patients. The most common form is C. neoformans. In the Northwestern United States, C. gattii has received considerable attention secondary to increased virulence resulting in significant morbidity and mortality. There are no cases in the extant literature describing a patient with C. gattii requiring neurosurgical intervention in Alabama. A middle-aged immunocompetent male with no recent travel or identifiable exposure presented with meningitis secondary to C. gattii. The patient underwent 12 lumbar punctures and a ventriculoperitoneal shunt and required 83 days of inpatient therapy with 5-flucytosine and amphotericin B. The patient was found to have multiple intracranial lesions and a large intramedullary spinal cryptococcoma within his conus. Following an almost 3-month hospitalization the patient required treatment with oral voriconazole for one year. In the United States meningitis caused by C. gattii infection is not isolated to the Northwestern region.