Cryptococcal meningitis in a patient with chronic hepatitis C treated with pegylated-interferon and ribavirin.
10.3904/kjim.2014.29.3.370
- Author:
Tae Hee LEE
1
;
Kee Ook LEE
;
Yong Seok KIM
;
Sun Moon KIM
;
Kyu Chan HUH
;
Young Woo CHOI
;
Young Woo KANG
Author Information
1. Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea. green740@naver.com
- Publication Type:Case Reports
- Keywords:
Cryptococcus;
Meningitis;
PEG-interferon-alpha;
Ribavirin;
Hepatitis C
- MeSH:
Antifungal Agents/therapeutic use;
Antiviral Agents/*adverse effects;
Cryptococcus neoformans/immunology/*pathogenicity;
Drug Therapy, Combination;
Female;
Hepatitis C, Chronic/diagnosis/*drug therapy/immunology;
Humans;
Immunocompromised Host;
Interferon-alpha/*adverse effects;
Meningitis, Cryptococcal/drug therapy/immunology/*microbiology;
Middle Aged;
Opportunistic Infections/diagnosis/drug therapy/immunology/*microbiology;
Polyethylene Glycols/*adverse effects;
Recombinant Proteins/adverse effects;
Ribavirin/*adverse effects;
Time Factors;
Treatment Outcome
- From:The Korean Journal of Internal Medicine
2014;29(3):370-374
- CountryRepublic of Korea
- Language:English
-
Abstract:
Various adverse events have been reported during combination therapy with pegylated (PEG)-interferon-alpha and ribavirin, although opportunistic infections, especially cryptococcal meningitis, are very rare. A 61-year-old woman complained of headaches and a fever during treatment of a chronic hepatitis C virus (HCV) infection. She had been treated for 7 months. Her headaches were refractory to analgesics, and she developed subtle nuchal rigidity. The cerebral spinal fluid (CSF) revealed a white blood cell count of 205/mm3, 51 mg/dL protein, 35 mg/dL glucose, and negative Cryptococcus antigen. The CSF culture resulted in no growth. Five days later, the CSF was positive for Cryptococcus antigen. We administered amphotericin B and flucytosine, followed by fluconazole. Approximately 2 months later, she was discharged. For the first time, we report a case of cryptococcal meningitis during the treatment of chronic HCV with PEG-interferon-alpha and ribavirin.
