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Research Article Open access CC BY 4.0

Pulmonary Cryptococcosis Co-existing with Pulmonary Tuberculosis in a Nigerian HIV-infected Patient: A Case Report

O. F. Nwako, E. O. Ofondu, G. C. Mbata, C. O. U. Eke, A. B. Nwako, P. Obi, C. A. Nwako, M. O. Iroezindu

International Journal of TROPICAL DISEASE & Health · pp. 1–5 · Published 12 Apr 2016

10.9734/IJTDH/2016/25157

Abstract

Tuberculosis (TB) and cryptococcosis cause severe morbidity and mortality in HIV-infected individuals in sub-Saharan Africa. However, cryptococcosis and TB co-infection is rare. We present a case of pulmonary cryptococcosis co-existing with pulmonary TB in a 42 year old Nigerian woman who had received Highly Active Antiretroviral Therapy (HAART) for about 6 months with CD4 count of 98 cells/mm3. In the second month of HAART, she developed smear positive TB and was commenced on anti-TB therapy. Following initial improvement, she developed new onset cough, low grade fever, weight loss, breathlessness and chest pain. Repeat sputum Acid Fast Bacilli (AFB) was negative but GeneXpert/MTB/Rif detected Mycobacterium tuberculosis (MTB) with no resistance to Rifampicin. Sputum fungal culture and Indian ink staining confirmed cryptococcosis. The patient was commenced on oral fluconazole therapy; anti-TB and HAART were continued. She subsequently improved but was unfortunately lost to follow-up. Pulmonary cryptococcosis should be considered in the differential diagnosis of severely immunosuppressed HIV-infected patients with chronic respiratory symptoms.

Pulmonary cryptococcosis tuberculosis HIV/AIDS Nigeria

References (7)

  1. 1 Updated Guidelines for the Use of Nucleic Acid Amplification Tests in the Diagnosis of Tuberculosis [DOI]
  2. 2 Pulmonary manifestations of the immune reconstitution inflammatory syndrome [DOI]
  3. 3 The Prevalence and Clinical Course of HIV-Associated Pulmonary Cryptococcosis in Uganda [DOI]
  4. 4 Cryptococcosis and tuberculosis co-infection at a university hospital in Taiwan, 1993–2006 [DOI]
  5. 5 Cryptococcal meningitis associated with tuberculosis in HIV infected patients.
  6. 6 Prevalence of pulmonary cryptococcosis in hiv/aids patients [DOI]
  7. 7 Mycological Studies on the Sputa of HIV Positive Clients Attending HIV Clinic in Federal Medical Centre Owerri, Nigeria [DOI]

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