Spontaneous cryptococcal peritonitis with fungemia in patients with decompensated cirrhosis: Report of two cases |
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Authors: | Chinmaya Kumar Bal Vikram Bhatia Vikas Khillan Neha Rathor Deepak Saini Ripu Daman Shiv Kumar Sarin |
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Institution: | From: Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India;1.Department of Microbiology, Institute of Liver and Biliary Sciences, New Delhi, India;2.Department of Critical Care Medicine, Institute of Liver and Biliary Sciences, New Delhi, India |
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Abstract: | Cryptococcus neoformans is encapsulated yeast that predominately infects immunocompromised individuals. Liver disease is an under-recognized predisposition for cryptococcal disease. We report two nonalcoholic, nondiabetic, and human immunodeficiency virus - negative cirrhotic patients, with spontaneous cryptococcal peritonitis. Cryptococcus infection was diagnosed by culture of ascitic fluid and peripheral blood in both. We treated the first patient with amphotericin-B, but he expired. The second patient with earlier diagnosis, survived to discharge with fluconazole treatment. We suggest a high clinical suspicion for Cryptococcus as a possible etiology of spontaneous peritonitis in cirrhotic patients. |
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Keywords: | Cirrhosis Cryptococcus neoformans India ink staining spontaneous bacterial peritonitis spontaneous cryptococcal peritonitis |
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