Difficulty diagnosing chronic cryptococcal meningitis in idiopathic CD4+ lymphocytopenia

被引:0
|
作者
Giuseppe Sancesario
Giampiero Palmieri
Gemma Viola
Carla Fontana
Alessandra Perfetti
Lucia Anemona
Roberto Floris
Simone Marziali
Giorgio Bernardi
Luigi Giusto Spagnoli
机构
[1] Università di Roma Tor Vergata,Dipartimento di Neuroscienze
[2] University of Rome Tor Vergata,Department of Biopathology
[3] University of Rome Tor Vergata,Department of Internal Medicine
[4] Santa Lucia Foundation,undefined
来源
Neurological Sciences | 2011年 / 32卷
关键词
Cryptococcosis; Idiopathic CD4 lymphocytopenia; Macrophages; Electron microscopy;
D O I
暂无
中图分类号
学科分类号
摘要
A 64-year-old man with idiopathic CD4+ lymphocytopenia developed cognitive impairment and gait ataxia with isolated obstructive hydrocephalus, which was fatal. Cerebrospinal fluid showed mild pleocytosis, but the etiology was not revealed by extensive analysis. At autopsy, inflammatory cells, CD8+ lymphocytes and abundant macrophages but not CD4+ lymphocytes were infiltrating the meninges at the base of the brain. Electron microscopy demonstrated that inflammation was caused by Cryptococcus neoformans, which was localized exclusively within macrophages, where it grew with budding. Our study suggests that, in idiopathic CD4+ lymphocytopenia, macrophages can efficiently phagocytize but inefficiently digest C. neoformans, thus representing a vehicle of chronic intracellular infection.
引用
收藏
页码:519 / 524
页数:5
相关论文
共 50 条
  • [41] IDIOPATHIC CD4+ T-LYMPHOCYTOPENIA IN 2 PATIENTS
    OSTROWSKI, M
    SALIT, IE
    GOLD, WL
    SUTTON, D
    MONTPETIT, ML
    LEPINE, D
    SALAS, T
    CANADIAN MEDICAL ASSOCIATION JOURNAL, 1993, 149 (11) : 1679 - 1683
  • [42] Idiopathic CD4+ lymphocytopenia: Natural history and prognostic factors
    Zonios, Dimitrios
    Falloon, Judith
    Bennett, John
    Shaw, Pamela
    Chaitt, Doreen
    Polis, Michael
    Kovacs, Joseph
    Davey, Richard
    Lane, H. Clifford
    Masur, Henry
    Sereti, Irini
    INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES, 2008, 12 : S7 - S7
  • [43] A case of progressive multifocal leukoencephalopathy and idiopathic CD4+ lymphocytopenia
    Patel, Amila
    Patel, Julie
    Ikwuagwu, Judy
    JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2010, 65 (12) : 2697 - 2698
  • [44] Cryptococcal meningits and pulmonary cryptococcoma in a patient with idiopathic CD4 lymphocytopenia
    Rodríguez, JM
    Andía, A
    Carreras, F
    Aberasturi, A
    Anaut, P
    García, F
    ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA, 2001, 19 (05): : 236 - 236
  • [45] IDIOPATHIC CD4+ T-LYMPHOCYTOPENIA - A QUANTITATIVE VIEW
    REICHERT, TA
    LANCET, 1993, 341 (8845): : 636 - 636
  • [46] Treatment of progressive multifocal leukoencephalopathy and idiopathic CD4+ lymphocytopenia
    Patel, Amila
    Patel, Julie
    Ikwuagwu, Judy
    JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2010, 65 (12) : 2489 - 2492
  • [47] CD4+ LYMPHOCYTOPENIA AND SARCOIDOSIS
    MONTERO, LC
    BARBON, DR
    MOSQUERA, JF
    LOPEZ, JBD
    MEDICINA CLINICA, 1995, 105 (04): : 158 - 158
  • [48] Idiopathic CD4+ T-lymphocytopenia with Bowen's disease
    Hayashi, T
    Hinoda, Y
    Takahashi, T
    Adachi, M
    Miura, S
    Izumi, T
    Kojima, H
    Yano, S
    Imai, K
    INTERNAL MEDICINE, 1997, 36 (11) : 822 - 824
  • [49] Idiopathic CD4+ T-cell lymphocytopenia associated with vitiligo
    Yamauchi, PS
    Nguyen, NQ
    Grimes, PE
    JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 2002, 46 (05) : 779 - 782
  • [50] Cryptococcus neoformans Meningoencephalitis in a Patient with Idiopathic CD4+ T Lymphocytopenia
    Pavic, Ivica
    Cekinovic, Durdica
    Begovac, Josip
    Maretic, Tomislav
    Civljak, Rok
    Troselj-Vukic, Biserka
    COLLEGIUM ANTROPOLOGICUM, 2013, 37 (02) : 619 - 623