هدی نقشینه

People who are infected with Human Immunodeficiency Viruses (HIV) are more prone to opportunistic fungal infections than other patients. The immune system of these patients becomes weaker when they are also infected with Coronavirus disease (COVID-19). Involvement of the central nervous system caused by fungal infections in these patients is of concern and fatal if diagnosed late. The aim of this research is to investigate a woman with COVID-19 and HIV who was diagnosed with cryptococcal meningitis.

Case Report:

 The patient is a 53-year-old woman who complained of severe headache and nausea after infection with COVID-19. White blood cells, erythrocyte sedimentation rate, lymphocyte, creatinine, aspartate aminotransferase, alanine aminotransferase and blood urea nitrogen were increased compared to the standard level. Cerebrospinal fluid testing showed that glucose was lower and protein was higher than normal. Microscopic examination, staining and culture of cerebrospinal fluid deposits showed the presence of double wall yeasts similar to Cryptococcus. The patient was positive for COVID-19 and HIV. The level of CD4 (cluster of differentiation 4) was lower than the standard. The patient was treated with amphotericin B at a dose of 100 mg for two weeks and was discharged from the hospital after the conditions were stabilized.

Cryptococcal meningitis can often occur in immunosuppressive conditions such as HIV. Therefore, quick follow-up, diagnosis and treatment should be considered in these patients.