Mixed infection by Cryptococcus neoformans and Cryptococcus gattii and coinfection with paracoccidioidomycosis in PLHIV

• Published in: Medical mycology case reports Vol. 35; pp. 48 - 50
• Main Authors: de Faria Ferreira, Marcela, Brito-Santos, Fabio, Henrique Nascimento Theodoro, Pedro, de Abreu Almeida, Marcos, Lazera, Marcia dos Santos, Trilles, Luciana
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-03-2022; Elsevier
• Subjects: Case Report; Cryptococcal antigen (CrAg); Cryptococcosis; HIV; Lateral Flow Assay (LFA); Paracoccidioidomycosis; Paracoccidioidomycosis; Lateral Flow Assay (LFA); HIV; Cryptococcal antigen (CrAg); Cryptococcosis
• ISSN: 2211-7539; 2211-7539
• DOI: 10.1016/j.mmcr.2022.01.006

We present a rare condition of mixed C. neoformans and C. gattii infection in a person living with HIV with false-negative CrAg LFA in the CSF and co-infection with paracoccidioidomycosis. Signs and symptoms are relative to respiratory tract and skin, confounding with other opportunistic disease. After negatives CrAg LFA and Indian ink staining in CSF, there was isolation of C. gattii in sputum and C. neoformans in CSF, in addition to reagent serology (double immunodiffusion) for PCM with 1/16 titer. The patient was treated with amphotericin B and TMP-SMX with good clinical response and recovery of cellular immunity after initiation of antiretroviral therapy.