Cryptococcemia in an HIV-negative patient with decompensated liver cirrhosis

Abstract

Background: Cryptococcal infections have been mostly associated with immunocompromised individuals, 80–90% of whom have been HIV-positive patients. Increasingly, cryptococcal infections are being reported in cirrhotic patients who are HIV-negative. The underlying immunologic defects in cirrhotic patients seem to play an important role in predisposing them to cryptococcosis and affecting their morbidity and mortality. Case presentation: We present a case of disseminated cryptococcosis in an HIV-negative patient with underlying cirrhosis, who had rapid worsening of his hyponatremia with renal failure and was unable to recover, despite aggressive measures. Conclusion: Cryptococcus is a more common culprit of infections seen in cirrhotic patients than what it was previously known, and a high index of suspicion is required to diagnose these patients. Identification of poor prognostic factors, early diagnosis and intervention is crucial in the management of these patients.

Keywords

• cirrhosis
• disseminated cryptococcosis
• Cryptococcus
• fungal infections
• decompensated liver cirrhosis
• cryptococcemia
• HIV-negative