Disseminated Cryptococcal Gattii infection in a patient with anti-granulocyte-macrophage colony-stimulating-factor autoantibody: a case report

Abstract Background Cryptococcosis is an opportunistic fungal infection in immunocompromised patients. The major species include Cryptococcus grubii, Cryptococcus neoformans, and rarely, Cryptococcus gattii. Here we present a disseminated Cryptococcus gattii infection in a patient with elevated gran...

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Main Authors: Chi-Tung Chen, Mao-Wang Ho, Wei-Hsin Chung
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-024-10267-6
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author Chi-Tung Chen
Mao-Wang Ho
Wei-Hsin Chung
author_facet Chi-Tung Chen
Mao-Wang Ho
Wei-Hsin Chung
author_sort Chi-Tung Chen
collection DOAJ
description Abstract Background Cryptococcosis is an opportunistic fungal infection in immunocompromised patients. The major species include Cryptococcus grubii, Cryptococcus neoformans, and rarely, Cryptococcus gattii. Here we present a disseminated Cryptococcus gattii infection in a patient with elevated granulocyte-macrophage colony-stimulating-factor autoantibody which was successfully treated with antifungal therapy. Case presentation A 61-year-old healthy man presented with a 3-week history of blurred vision, low-grade fever, headache, and a one-year history of low back pain following a fall on his farm. Physical examination revealed lower back tenderness and diplopia. He was tested negative for hepatitis B, C, and human immunodeficiency virus. Chest X-ray revealed a focal opacity in the right retrocardiac paraspinal region and pleural effusion. Magnetic resonance imaging showed a mass located at the L1 prevertebral region and multiple rim-enhancing lesions in bilateral cerebral hemispheres. Thoracoscopy demonstrated cystic lesions at the right costopleural angle. Pathology and microbiology studies confirmed the diagnosis of disseminated Cryptococcus gatti infection. Autoantibodies to granulocyte-macrophage colony-stimulating factor were detected and were considered to cause disseminated cryptococcosis. The patient was started on amphotericin B followed by fluconazole treatment. One month later, the symptoms ameliorated and repeated image studies after 1 year of follow-up showed the resolution of lesions. Conclusion This report describes the first case of disseminated Cryptococcus gattii infection involving the musculoskeletal system, respiratory system, and central nervous system with granulocyte-macrophage colony-stimulating-factor autoantibody by evidence of histology and microbiology.
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spelling doaj-art-0b237951addc4b6fb22d6f9ca0ffc64d2024-12-22T12:17:24ZengBMCBMC Infectious Diseases1471-23342024-12-012411710.1186/s12879-024-10267-6Disseminated Cryptococcal Gattii infection in a patient with anti-granulocyte-macrophage colony-stimulating-factor autoantibody: a case reportChi-Tung Chen0Mao-Wang Ho1Wei-Hsin Chung2Division of Cardiovascular Medicine, Department of Internal Medicine, China Medical University HospitalDivision of Infectious Disease, Department of Internal Medicine, China Medical University HospitalDivision of Cardiovascular Medicine, Department of Internal Medicine, China Medical University HospitalAbstract Background Cryptococcosis is an opportunistic fungal infection in immunocompromised patients. The major species include Cryptococcus grubii, Cryptococcus neoformans, and rarely, Cryptococcus gattii. Here we present a disseminated Cryptococcus gattii infection in a patient with elevated granulocyte-macrophage colony-stimulating-factor autoantibody which was successfully treated with antifungal therapy. Case presentation A 61-year-old healthy man presented with a 3-week history of blurred vision, low-grade fever, headache, and a one-year history of low back pain following a fall on his farm. Physical examination revealed lower back tenderness and diplopia. He was tested negative for hepatitis B, C, and human immunodeficiency virus. Chest X-ray revealed a focal opacity in the right retrocardiac paraspinal region and pleural effusion. Magnetic resonance imaging showed a mass located at the L1 prevertebral region and multiple rim-enhancing lesions in bilateral cerebral hemispheres. Thoracoscopy demonstrated cystic lesions at the right costopleural angle. Pathology and microbiology studies confirmed the diagnosis of disseminated Cryptococcus gatti infection. Autoantibodies to granulocyte-macrophage colony-stimulating factor were detected and were considered to cause disseminated cryptococcosis. The patient was started on amphotericin B followed by fluconazole treatment. One month later, the symptoms ameliorated and repeated image studies after 1 year of follow-up showed the resolution of lesions. Conclusion This report describes the first case of disseminated Cryptococcus gattii infection involving the musculoskeletal system, respiratory system, and central nervous system with granulocyte-macrophage colony-stimulating-factor autoantibody by evidence of histology and microbiology.https://doi.org/10.1186/s12879-024-10267-6Disseminated Cryptococcal GattiiGranulocyte-macrophage colony stimulating factor AutoantibodyCase report
spellingShingle Chi-Tung Chen
Mao-Wang Ho
Wei-Hsin Chung
Disseminated Cryptococcal Gattii infection in a patient with anti-granulocyte-macrophage colony-stimulating-factor autoantibody: a case report
BMC Infectious Diseases
Disseminated Cryptococcal Gattii
Granulocyte-macrophage colony stimulating factor Autoantibody
Case report
title Disseminated Cryptococcal Gattii infection in a patient with anti-granulocyte-macrophage colony-stimulating-factor autoantibody: a case report
title_full Disseminated Cryptococcal Gattii infection in a patient with anti-granulocyte-macrophage colony-stimulating-factor autoantibody: a case report
title_fullStr Disseminated Cryptococcal Gattii infection in a patient with anti-granulocyte-macrophage colony-stimulating-factor autoantibody: a case report
title_full_unstemmed Disseminated Cryptococcal Gattii infection in a patient with anti-granulocyte-macrophage colony-stimulating-factor autoantibody: a case report
title_short Disseminated Cryptococcal Gattii infection in a patient with anti-granulocyte-macrophage colony-stimulating-factor autoantibody: a case report
title_sort disseminated cryptococcal gattii infection in a patient with anti granulocyte macrophage colony stimulating factor autoantibody a case report
topic Disseminated Cryptococcal Gattii
Granulocyte-macrophage colony stimulating factor Autoantibody
Case report
url https://doi.org/10.1186/s12879-024-10267-6
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AT maowangho disseminatedcryptococcalgattiiinfectioninapatientwithantigranulocytemacrophagecolonystimulatingfactorautoantibodyacasereport
AT weihsinchung disseminatedcryptococcalgattiiinfectioninapatientwithantigranulocytemacrophagecolonystimulatingfactorautoantibodyacasereport