Disseminated Cryptococcosis in a Non-HIV Patient in Singapore
Table 2
Further investigations (day 7–10) leading to diagnosis of disseminated cryptococcosis.
Test
Findings
Serum cryptococcal antigen (CRAG)
Titer ≥ 1 : 2560
Blood fungal culture
CN
Computed tomography (CT) thorax scan
Patchy areas of consolidation in the left perihilar region and right lower lobe along with scattered subcentimeter pulmonary nodules which suggested infective changes of pulmonary cryptococcosis on a background of fluid overload contributed by congestive cardiac failure and worsening renal function
CT brain scan
No space occupying lesion, no mass effect, and no intracranial hemorrhage or territorial infarcts
Lumbar puncture
Opening pressure
10.0 cm water
Cerebrospinal fluid (CSF) gram stain
Encapsulated blasticonidia (yeasts)
CSF fungal microscopy
Encapsulated blasticonidia seen, morphology suggestive of Cryptococcus
