Crypto C Cocus
Crypto C Cocus
Crypto C Cocus
CRYPTOCOCCUS
NEOFORMANS INFECTION
Ahmad Danial
(Chayakulkeeree M, 2006).
CASE
IDENTITY :
• Foto klinis pasien
Name : Mr. T
Sex : Male
Age : 43 yrs
Address : Surabaya
Occupation :
HISTORY
Chief complain: • No chest pain
• Dyspnea • Fever 2 weeks PTA
Present illness • No night sweating
• Dyspnea since 2 • Lost of appetite 4
weeks prior to months PTA
admission (PTA) • Weight loss 12 kgs in
• Cough 4 months
• Thick sputum • Oral ulcer+
• No headache or
seizure
HISTORY
Past illness:
• The history of DM,HT, and Tuberculosis
were denied
• Smoking and alcohol +
• History of drug abuse and free sex were
denied
• Was diagnosed with HIV at Soewandhie
Hospital 2 weeks PTA
Physical Examination
anemia (-)
GCS 346, somnolent ict (-)/ cyan (-)
/dysp (+)
Vital Sign:
BP 100/70 mmHg Ronchi + on 2/3
Pulse 111 bpm both hemithorax
Resp rate 30-32 tpm
Axillary temp 38,30 C
SpO2 97 % Within
normal limit
Within
normal limit
LABORATORY FINDINGS
CBC Chemistry Panel ABG Urinalysis
Hb 10,8 BUN 17 pH 7,52 Gluc -
HCT 33,3% Scr 0,98 pCO2 29 Bil -
MCV 93,4 GDA 93 pO2 52,2 Keto -
MVH 30,2 Alb 2,58 HCO3 24,2 SG 1,008
MCHC 32,4 SGOT 24 BE 1,0 Bld -
leuco 6510 SGPT 14 SO2 90,4% pH 6,9
Gran 85,6% D Bil 0,30 AaDO2 58,7 prot -
PLT 257000 T Bil 0,56 Nit -
Na 142 Leu trace
K 4,3 Color yellow
Cl 104 Clar clear
eri 0-2/lp
leu 0-2/lp
Supportive Examination
• cxr • Cor: within normal limit
• Pulmo: Reticulogranular
pattern in both hemithorax.
Trachea in the middle, left
and right costophrenicus
angle were sharp,. Soft tissue
does not appear
abnormalities. The visualized
bone looks good.
Supportive Examination
• Gambar ct scan
S : cough +
O: BP : 110/80 HR : 83bpm RR : 20 t : 36,6
A: AIDS
Cryptoccoccus Neoformans infection
Respiratory Failure (improved)
Candidiasis Oris
Hipoalbumin (Improved)
(Brinzedine, et al,2011).
• Any patients with HIV infection
presenting with subacute/ chronic
headache, particularly those who
are CD4-deplete, should be On this Patient:
investigated for CM. Lumbar
puncture should be performed to On the fifth day of treatment we
measure opening pressure, found the results of examination
cerebrospinal fluid (CSF) cell of gram sputum germicoccus
counts, biochemistry and culture, gram posap positive gram
CSF CrAg, Gram stain and India staphylococcus hominis and
ink, along with serum CrAg, yeast cell formation is
blood culture and chest X-ray. cryptococcus neoformans. The
CT or MRI brain scans are result of blood culture
helpful in assessing examination was adapted yeast
cryptococcomas, meningeal cell formation cryptococcus
inflammation, vasculitis and neoformans and we follow up with
ventricular compression. LFA examination. On the eighth
• The new lateral flow assay (LFA) day of treatment we got positive
for measuring cryptococcal LVA flow assay (LFA)
antigen designed as a point-of-
care test has performed well (>
95% sensitivity and 100%
specificity)
(Kabanda, 2014 ; Kohno, 2015)
Therapy