Introduction:
Cryptococcus neoformans (C. neoformans) is a fungus which infects the lungs, meninges, skin and the nervous system. In tropical countries prevalent with tuberculosis (TB), initial clinical presentations of a C. neoformans infection can normally be mistaken as a TB infection. The C. neoformans infection shall then form part of the differential diagnosis. Exposure to C. neoformans does not usually manifest as an infection however, in immunocompromised patients this results to cryptococcosis.
Case:
This is a case of a 33-year-old male who was admitted due to febrile seizures. He was suspected to be in an immunocompromised state due to multiple sexual partners. A non-tender, mobile left cervical lymphadenopathy was subjected to FNAB (fine needle aspiration biopsy) surprisingly came out to be cryptococcal in nature. He was managed as a case of disseminated cryptococossis with meningeal extension. He was given amphotericin B and fluconazole.
Conclusion
The most common suspected cause of lymphadenitis in the Philippines is attributed to TB. The high index of suspicion based on sound medical history and physical examination can lead the clinician into considering an uncommon cause of lymphadenopathy most especially in patients with high likelihood of immunocompromised state.
Cryptococcosis
;
Meningitis, Cryptococcal
;
HIV