Author:
Fang Li,Zhang Junli,Lv Fangfang
Abstract
Abstract
Background
Idiopathic CD4 + T lymphocytopenia (ICL) is a rare immunodeficiency syndrome, unaccompanied by various opportunistic infections. Cryptococcus and varicella-zoster viruse are the most common opportunistic infections.
Method
We described a case of disseminated cryptococcosis with varicella-zoster virus coinfection in a patient with ICL and reviewed all published reports. A total of 26 cases with cryptococcal meningitis in ICL were enrolled.
Discussion
ICL remains poorly understood to clinicians. Patients with cryptococcal meningitis in ICL mostly suffered with headache and fever in a subacute or chronic period, while some patients might have atypical manifestations which makes a difficulty for early diagnosis. Some characteristics of cerebrospinal fluid can help to predict the prognosis of the disease. Cryptococcosis with varicella-zoster virus coinfection is rare but serious.
Conclusion
We recommed CD4 + T cells should be assessed in patients with unusual or recurrent infections. As the underlying pathophysiology is poorly understood, there is no standard therapy for ICL. Increased awareness of the disease and early prevention for CD4 reduction are needed.
Funder
Zhejiang Medical and Health Science and Technology Program
Publisher
Springer Science and Business Media LLC
Subject
Infectious Diseases,Virology
Reference47 articles.
1. Yarmohammadi H, Cunningham-Rundles C. Idiopathic CD4 lymphocytopenia: pathogenesis, etiologies, clinical presentations and treatment strategies. Ann Allergy Asthma Immunol. 2017;119(4):374–8.
2. Centers for Disease Control (CDC). Unexplained CD4+ T-lymphocyte depletion in persons without evident HIV infection—United States. MMWR Morb Mortal Wkly Rep. 1992;41:541.
3. Sloan DJ, Parris V. Cryptococcal meningitis: epidemiology and therapeutic options. Clin Epidemiol. 2014;6:169–82.
4. Rajasingham R, Smith RM, Park BJ, et al. Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis. Lancet Infect Dis. 2017;17:873–81.
5. Wilson LS, Reyes CM, Stolpman M, et al. The direct cost and incidence of systemic fungal infections. Value Health. 2002;5:26–34.
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献