Cryptococcal meningoencephalitis in multiple sclerosis treated with fingolimod
Cryptococcal meningoencephalitis in multiple sclerosis treated with fingolimod
A 21-year-old woman with multiple sclerosis (taking regular fingolimod) developed sudden-onset severe headache with nausea and malaise. Neurological examination was normal and she was afebrile. Blood results showed lymphocytes 0.53 x 109/L and C reactive protein 19 mg/L. CT scan of head and venogram were normal. CSF showed an opening pressure of 33 cm H2O and an incidental light growth of Cryptococcus neoformans, confirmed with positive India Ink stain and a positive cryptococcal antigen (1:100). She was treated for cryptococcal meningoencephalitis with amphotericin and flucytosine. Her presenting symptoms had closely mimicked subarachnoid haemorrhage. This atypical presentation of cryptococcal CNS infection highlights the need for vigilance in immunosuppressed patients.
INFECTIOUS DISEASES, MICROBIOLOGY, SUBARACHNOID HAEMORRHAGE
512–515
Nasir, Moneeb
16e2733e-5f4e-4df8-99ff-ad2c90148e25
Galea, Ian
66209a2f-f7e6-4d63-afe4-e9299f156f0b
Neligan, Aidan
40418bd4-85a5-4ac5-be70-c99f290008cd
Chung, Karen
378e430b-b5f0-4173-93fa-646558c6cec0
1 December 2023
Nasir, Moneeb
16e2733e-5f4e-4df8-99ff-ad2c90148e25
Galea, Ian
66209a2f-f7e6-4d63-afe4-e9299f156f0b
Neligan, Aidan
40418bd4-85a5-4ac5-be70-c99f290008cd
Chung, Karen
378e430b-b5f0-4173-93fa-646558c6cec0
Nasir, Moneeb, Galea, Ian, Neligan, Aidan and Chung, Karen
(2023)
Cryptococcal meningoencephalitis in multiple sclerosis treated with fingolimod.
Practical Neurology, 23 (6), , [pn-2023-003691].
(doi:10.1136/pn-2023-003691).
Abstract
A 21-year-old woman with multiple sclerosis (taking regular fingolimod) developed sudden-onset severe headache with nausea and malaise. Neurological examination was normal and she was afebrile. Blood results showed lymphocytes 0.53 x 109/L and C reactive protein 19 mg/L. CT scan of head and venogram were normal. CSF showed an opening pressure of 33 cm H2O and an incidental light growth of Cryptococcus neoformans, confirmed with positive India Ink stain and a positive cryptococcal antigen (1:100). She was treated for cryptococcal meningoencephalitis with amphotericin and flucytosine. Her presenting symptoms had closely mimicked subarachnoid haemorrhage. This atypical presentation of cryptococcal CNS infection highlights the need for vigilance in immunosuppressed patients.
Text
Nasir et al 2023_author accepted manuscript
- Accepted Manuscript
More information
Accepted/In Press date: 27 June 2023
e-pub ahead of print date: 6 October 2023
Published date: 1 December 2023
Additional Information:
Publisher Copyright:
© Author(s) (or their employer(s)) 2023.
Keywords:
INFECTIOUS DISEASES, MICROBIOLOGY, SUBARACHNOID HAEMORRHAGE
Identifiers
Local EPrints ID: 485290
URI: http://eprints.soton.ac.uk/id/eprint/485290
ISSN: 1474-7758
PURE UUID: 113c3a20-ca88-4fdc-906a-a93707669b1e
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Date deposited: 04 Dec 2023 17:31
Last modified: 18 Mar 2024 02:57
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Contributors
Author:
Moneeb Nasir
Author:
Aidan Neligan
Author:
Karen Chung
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