Cryptococcal Meningitis Complicated by Escherichia coli Sepsis in a Patient with Liver Cirrhosis
Won-Gu Lee, MD1, Meyung-Kug Kim, MD1, Bong-Goo Yoo, MD1 and Ji Young Park, MD2
1Departments of Neurology, 2Internal Medicine, Kosin University College of Medicine, Busan, Korea
ABSTRACT
Background: Cryptococcal meningitis is one of the most serious central nervous system infection in immunocompromised patients. Among patients with cryptococcal meningitis, the presence of concomitant bacterial sepsis is rare. We report a fatal case of successfully treated cryptococcal meningitis complicated by bacterial sepsis in a patient with liver cirrhosis. Case Report: A 56-year-old female with liver cirrhosis was admitted to the hospital because of severe headache, fever and vomiting for 4 days. She was diagnosed as cryptococcal meningitis and treated with amphotericin B. During hospitalization, she became progressively worse and her mental status deteriorated. We suspected bacterial sepsis and immediately administered broad spectrum antibiotics. We have successfully treated cryptococcal meningitis accompanied by bacterial sepsis in a patient with liver cirrhosis. Conclusions:Clinician should consider the possibility of other infection in unexplained clinical deterioration despite of appropriate treatment in cryptococcal meningitis.
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