Case Report

Disseminated cryptococcosis with meningitis, peritonitis, and cryptococcemia in a HIV-negative patient with cirrhosis: a case report

Baligh Ramzi Yehia, Michael Eberlein, Stephen D Sisson and David N Hager

Department of Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 9020, Baltimore, Maryland, USA

Cases Journal 2009, 2:170doi:10.1186/1757-1626-2-170

Published:	28 October 2009

Abstract

Introduction

Cryptococcus neoformans is an encapsulated yeast that causes serious infections in immunocompromised populations. The majority of cases occur in HIV-infected individuals. Disseminated disease is uncommon, and very rarely includes peritonitis.

Case presentation

We report a case of a 41-year-old, HIV-negative, Caucasian man with alcoholic liver cirrhosis who presented with fever and seizure. Disseminated cryptococcosis with meningitis, peritonitis, and cryptococcemia was diagnosed, and despite adequate treatment the patient developed multi-system organ failure and eventually expired.

Conclusion

Disseminated cryptococcosis, particularly with peritonitis, is an uncommon manifestation of Cryptococcus neoformans infection. Liver cirrhosis serves as a risk factor for disseminated disease in HIV-negative patients. A high clinical suspicion and early initiation of therapy is needed to recognize and treat patients effectively.