Gastrointestinal Cryptococcosis Associated with Intestinal Lymphangiectasia

Table 1

Case reports of intestinal cryptococcosis in the context of immunosuppressing conditions.

	Immune status	Age	Presentation	Endoscopy	Place of infection
Case 1	Immunocompetent	37	Abdominal pain (6 months), melena, fever	Ulcerated and elevated lesions	Sigma, blind and ileocecal valve
Chavapradit and Angkasekwinai [4]	Immunosuppressive therapy	64	Abdominal pain	Inflammation of the mucosa, whitish exudates	Blind, ascending colon
Eyer-Silva et al. [5]	HIV infection (CD4 10/mm^3)	34	Abdominal pain (2 months), nausea and vomiting	High lesions flushed with central ulcer	Stomach
Osawa and Singh [6]	Immunosuppressive therapy	53	Intermittent abdominal pain, fever, and diarrhea	Linear ulcer	Ileus terminal
Sundar et al. [7]	HIV infection (ART not started)	48	Uncontrollable vomiting (3 days)	Macroscopic erosion	Stomach
Liu [8]	AIDS	54	Fever, diarrhea, and fever (8 days)	Irregular ulcers, violet pigmented lesions	Stomach, duodenal bulb and second portion of the duodenum
Musubire et al. [9]	HIV infection (CD4 5 cells/mL)	37	Abdominal pain fever	Lymphadenopathy	Ileus
Girardin et al. [10]	HIV infection (3 cells/mL)	26	Epigastric pain (3 weeks), bilious vomiting, fever	Patched lesions, with whitish villi	Duodenum
Cicora et al. [11]	Immunosuppressive therapy	59	Diarrhea	Unique ulcer	Large intestine
Sciaudone et al. [3]	Immunocompetent	26	Abdominal pain, fever, diarrhea, and melena	Hyperemic mucosa, ulcer	Sigmoid colon
Hokari et al. [12]	Primary biliary cirrhosis	58	Fever, diarrhea	Pseudopolyposis	Small and large intestine
Association	Image	Complications	Management
Lymphangiectasia	CT: small bowel edema	Without complications	Fluconazole 800 mg IV
Crohn’s disease	Thickening and edema of cecum, ileocecal valve, and terminal ileum	Dissemination	Amphotericin B 0.7 mg/kg daily for 6 weeks. Fluconazole 200 mg/day for one year
Meningoencephalitis	Not reported	Not reported	Amphotericin B followed by fluconazole
Crohn’s disease	No significant changes	Dissemination	Amphotericin B followed by fluconazole 40 mg day (19 days)
Herpes simplex type I	Not reported	Not reported	Amphotericin B
Sepsis	Ulcer at the level of the antrum with central reddish ulceration	Multiorgan failure	Amphotericin B, fluconazole, pantoprazole IV
Not reported	Ultrasound: thickening of the ileum wall. Rx abdominal: signs of perforation	Not reported	Not reported
Transplanted kidney	Not reported	Not reported	Amphotericin B (8 days), fluconazole 800 mg daily (3 months)
Not reported	CT: hypertrophic right lobe in liver, thickening of the wall of the cecum, and transverse colon	Not reported	Fluconazole 400 mg daily (1 week); 200 mg (5 weeks)
Liver dysfunction, pneumonia	CT: intestinal distention, fluid accumulation	Multiorgan failure	Antibiotics