Non-Neoformans Pulmonary Cryptococcosis Due to Cryptococcus Laurentii in a Positive SARS-COV-2 Patient
Abstract
Non-neoformans Cryptococcus species were formerly considered to be saprophytes and nonpathogenic to humans [1-2]. However, the incidence of Cryptococcus laurentii infections in immunocompromised and immunocompetent patients has been gradually increasing over the last decades [1-2]. During the COVID-19 pandemic, multiple cases of opportunistic bacterial and fungal infections have been reported in patients after a severe SARS-CoV-2 infection. The author reports the first case of opportunistic pulmonary cryptococcosis caused by Cryptococcus laurentii in a severely ill COVID-19 patient who received treatment with Tocilizumab and dexamethasone. This case contributes to the expanding knowledge of emergent secondary infectious complications including opportunistic pathogens after a SARS-COV-2 infection.
1. Setianingrum F, Rautemaa-Richardson R, Denning DW. Pulmonary cryptococcosis: A review of Pathobiology and clinical aspects. Medical Mycology. 2018;57(2):133-50. https:// doi.org/10.1093/mmy/myy086
2. Cano EJ, Yetmar ZA, Razonable RR. Cryptococcus Species Other Than Cryptococcus neoformans and Cryptococcus gattii: Are They Clinically Significant? Open Forum Infectious Diseases. 2020;7(12). https://doi.org/10.1093/ofid/ofaa527
3. Khawcharoenporn T, Apisarnthanarak A, Mundy LM. Non- neoformans Cryptococcal Infections: a Systematic Review. Infection. 2007;35(2). https://doi.org/10.1007/s15010-007- 6142-8
4. Johnson LB, Bradley SF, Kauffmann CA. Fungaemia due to Cryptococcus laurentii and a review of non-neoformans cryptococcaemia. Mycoses. 1998;41:277-80. https://doi. org/10.1111/j.1439-0507.1998.tb00338.x
5. Kamalam A, Yesudian P, Thambiah AS. Cutaneous infection by Cryptococcus laurentii. Br J Dermatol. 1977;97:221-3. https:// doi.org/10.1111/j.1365-2133.1977.tb15070.x
6. Kordossis T, Avlami A, Velegraki A, et al. First report of Cryptococcus laurentii Cryptococcus albidus cryptococcaemia in AIDS patients. Med Mycol. 1998;36:335-9. https://doi.org/10.1080/02681219880000521
7. Ritterband DC, Seedor JA, Shah MK, Waheed S, Schorr I. A unique case of Cryptococcus laurentii keratitis spread by a rigid gas permeable contact lens in a patient with onychomycosis. Cornea. 1998;17:115-8. https://doi.org/10.1097/00003226- 199801000-00017
8. EM Shankar, N Kumarasamy, D Bella, et al. Pneumonia and pleural effusion due to Cryptococcus laurentii in a clinically proven case of AIDS. Can Respir J. 2006;13(5):275-278. https:// doi.org/10.1155/2006/160451
9. Banerjee P, Haider M, Trehan V, Mishra B, Thakur A, Dogra V, et al. Cryptococcus laurentii Fungemia. Indian Journal of Medical Microbiology. 2013;31(1):75-7. https://doi.org/10.4103/0255- 0857.108731
10. Huang H, Pan J, Yang W, Lin J, Han Y, Lan K, et al. First case report of Cryptococcus laurentii knee infection in a previously healthy patient. BMC Infectious Diseases. 2020;20(1). https:// doi.org/10.1186/s12879-020-05401-z
11. Bhat V, Vira H, Khattry N, Toshniwal M. Cryptococcus laurentiidiarrhea post hematopoietic stem cell transplant. Transplant Infectious Disease. 2017;19(2). https://doi. org/10.1111/tid.12663
12. Molina-Leyva A, Ruiz-Carrascosa JC, Leyva-Garcia A, Husein- Elahmed H. Cutaneous Cryptococcus laurentii infection in an immunocompetent child. International Journal of Infectious Diseases. 2013;17(12). https://doi.org/10.1016/j. ijid.2013.04.017
13. Mattsson R, Haemig PD, Olsen B. Feral pigeons as carriers of Cryptococcus laurentii, Cryptococcus uniguttulatus and Debaryomyces hansenii. Med Mycol. 1999;37:367-9. https:// doi.org/10.1046/j.1365-280X.1999.00241.x
14. Cafardi J, Haas D, Lamarre T, Feinberg J. Opportunistic Fungal Infection Associated With COVID-19. Open Forum Infect Dis. 2021;8(7). https://doi.org/10.1093/ofid/ofab016
15. Khatib MY, Ahmed AA, Shaat Said B, Mohamed AS, Nashwan. AJ. Cryptococcemia in a patient with COVID-19: a case report. Clin Case Rep. 2021;9(2):853-5. https://doi.org/10.1002/ ccr3.3668
16. Passerini M, Terzi R, Piscaglia M, Passerini S, Piconi S. Disseminated cryptococcosis in a patient with metastatic prostate cancer who died in the coronavirus disease 2019 (COVID-19) outbreak. Cureus. 2020;12(5):8254-e. https://doi. org/10.7759/cureus.8254
17. Ghanem H, Sivasubramanian G. Cryptococcus neoformans Meningoencephalitis in an Immunocompetent Patient after COVID-19 Infection. Case Reports in Infectious Diseases. 2021;2021:1-3. https://doi.org/10.1155/2021/5597473
18. Thota DR, Ray B, Hasan M, Sharma K. Cryptococcal meningoencephalitis during convalescence from severe COVID-19 pneumonia. The Neurohospitalist. 2021. https://doi. org/10.1177/19418744211009766
19. Passarelli VC, Perosa AH, de Souza Luna LK, Conte DD, Nascimento OA, Ota-Arakaki J, et al. Detected SARS-CoV-2 in Ascitic fluid followed by cryptococcemia: a case report. SN Compr Clin Med. 2020;2(11):2414-8. https://doi.org/10.1007/ s42399-020-00574-9
20. Woldie IL, Brown IG, Nwadiaro NF, Patel A, Jarrar M, Quint E, et al. Autoimmune hemolytic anemia in a 24-year-old patient with COVID-19 complicated by secondary cryptococcemia and acute necrotizing encephalitis: a case report and review of literature. J Med Cases. 2020;11(11):362-5. https://doi.org/10.14740/ jmc3575
21. Restrepo HF, Lara CG, Alvarez MM. Disseminated cryptococcosis in a positive patient for COVID-19 [Spanish]. Revista Repertorio de Medicina y Cirugía. 2021;:46-50. https://doi.org/10.31260/ RepertMedCir.01217372.1209
22. Limper AH. The changing spectrum of fungal infections in pulmonary and critical care practice: clinical approach to diagnosis. Proc Am Thorac Soc.2010; 7: 163-168. https://doi. org/10.1513/pats.200906-049AL
23. Song KD, Lee KS, Chung MP, et al. Pulmonary cryptococcosis: imaging findings in 23 non-AIDS patients. Korean J Radiol. 2010;11(4):407-416. https://doi.org/10.3348/kjr.2010.11.4.407
24. Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clinical Infectious Diseases. 2020;71(15):762-8. https://doi.org/10.1093/cid/ciaa248
25. Liu J, Li S, Liu J, Liang B, Wang X, Li W, et al. Longitudinal Characteristics of Lymphocyte Responses and Cytokine Profiles in the Peripheral Blood of SARS-CoV-2 Infected Patients. SSRN Electronic Journal. 2020; 55. https://doi.org/10.2139/ ssrn.3539682
26. Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. Journal of Clinical Investigation. 2020;130(5):2620-9. https://doi.org/10.1172/JCI137244
27. Brown MJ, Alazawi W, Kanoni S. Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19. N Engl J Med. 2021 Sep 16;385(12):1147. https://doi.org/10.1056/ NEJMc2108482
28. Recovery Collaborative Group. Tocilizumab in patients admitted to controlled, open-label, platform trial. Lancet. 2021;397(10285):1637- 1645. https://doi.org/10.1101/2021.02.11.21249258
29. Pettit NN, Nguyen CT, Mutlu GM, Wu D, Kimmig L, Pitrak D, et al. Late Onset Infectious Complications and Safety Of Tocilizumab In The Management of COVID-19. Journal of Medical Virology. 2020;93(3):1459-64. https://doi.org/10.1002/jmv.26429
2. Cano EJ, Yetmar ZA, Razonable RR. Cryptococcus Species Other Than Cryptococcus neoformans and Cryptococcus gattii: Are They Clinically Significant? Open Forum Infectious Diseases. 2020;7(12). https://doi.org/10.1093/ofid/ofaa527
3. Khawcharoenporn T, Apisarnthanarak A, Mundy LM. Non- neoformans Cryptococcal Infections: a Systematic Review. Infection. 2007;35(2). https://doi.org/10.1007/s15010-007- 6142-8
4. Johnson LB, Bradley SF, Kauffmann CA. Fungaemia due to Cryptococcus laurentii and a review of non-neoformans cryptococcaemia. Mycoses. 1998;41:277-80. https://doi. org/10.1111/j.1439-0507.1998.tb00338.x
5. Kamalam A, Yesudian P, Thambiah AS. Cutaneous infection by Cryptococcus laurentii. Br J Dermatol. 1977;97:221-3. https:// doi.org/10.1111/j.1365-2133.1977.tb15070.x
6. Kordossis T, Avlami A, Velegraki A, et al. First report of Cryptococcus laurentii Cryptococcus albidus cryptococcaemia in AIDS patients. Med Mycol. 1998;36:335-9. https://doi.org/10.1080/02681219880000521
7. Ritterband DC, Seedor JA, Shah MK, Waheed S, Schorr I. A unique case of Cryptococcus laurentii keratitis spread by a rigid gas permeable contact lens in a patient with onychomycosis. Cornea. 1998;17:115-8. https://doi.org/10.1097/00003226- 199801000-00017
8. EM Shankar, N Kumarasamy, D Bella, et al. Pneumonia and pleural effusion due to Cryptococcus laurentii in a clinically proven case of AIDS. Can Respir J. 2006;13(5):275-278. https:// doi.org/10.1155/2006/160451
9. Banerjee P, Haider M, Trehan V, Mishra B, Thakur A, Dogra V, et al. Cryptococcus laurentii Fungemia. Indian Journal of Medical Microbiology. 2013;31(1):75-7. https://doi.org/10.4103/0255- 0857.108731
10. Huang H, Pan J, Yang W, Lin J, Han Y, Lan K, et al. First case report of Cryptococcus laurentii knee infection in a previously healthy patient. BMC Infectious Diseases. 2020;20(1). https:// doi.org/10.1186/s12879-020-05401-z
11. Bhat V, Vira H, Khattry N, Toshniwal M. Cryptococcus laurentiidiarrhea post hematopoietic stem cell transplant. Transplant Infectious Disease. 2017;19(2). https://doi. org/10.1111/tid.12663
12. Molina-Leyva A, Ruiz-Carrascosa JC, Leyva-Garcia A, Husein- Elahmed H. Cutaneous Cryptococcus laurentii infection in an immunocompetent child. International Journal of Infectious Diseases. 2013;17(12). https://doi.org/10.1016/j. ijid.2013.04.017
13. Mattsson R, Haemig PD, Olsen B. Feral pigeons as carriers of Cryptococcus laurentii, Cryptococcus uniguttulatus and Debaryomyces hansenii. Med Mycol. 1999;37:367-9. https:// doi.org/10.1046/j.1365-280X.1999.00241.x
14. Cafardi J, Haas D, Lamarre T, Feinberg J. Opportunistic Fungal Infection Associated With COVID-19. Open Forum Infect Dis. 2021;8(7). https://doi.org/10.1093/ofid/ofab016
15. Khatib MY, Ahmed AA, Shaat Said B, Mohamed AS, Nashwan. AJ. Cryptococcemia in a patient with COVID-19: a case report. Clin Case Rep. 2021;9(2):853-5. https://doi.org/10.1002/ ccr3.3668
16. Passerini M, Terzi R, Piscaglia M, Passerini S, Piconi S. Disseminated cryptococcosis in a patient with metastatic prostate cancer who died in the coronavirus disease 2019 (COVID-19) outbreak. Cureus. 2020;12(5):8254-e. https://doi. org/10.7759/cureus.8254
17. Ghanem H, Sivasubramanian G. Cryptococcus neoformans Meningoencephalitis in an Immunocompetent Patient after COVID-19 Infection. Case Reports in Infectious Diseases. 2021;2021:1-3. https://doi.org/10.1155/2021/5597473
18. Thota DR, Ray B, Hasan M, Sharma K. Cryptococcal meningoencephalitis during convalescence from severe COVID-19 pneumonia. The Neurohospitalist. 2021. https://doi. org/10.1177/19418744211009766
19. Passarelli VC, Perosa AH, de Souza Luna LK, Conte DD, Nascimento OA, Ota-Arakaki J, et al. Detected SARS-CoV-2 in Ascitic fluid followed by cryptococcemia: a case report. SN Compr Clin Med. 2020;2(11):2414-8. https://doi.org/10.1007/ s42399-020-00574-9
20. Woldie IL, Brown IG, Nwadiaro NF, Patel A, Jarrar M, Quint E, et al. Autoimmune hemolytic anemia in a 24-year-old patient with COVID-19 complicated by secondary cryptococcemia and acute necrotizing encephalitis: a case report and review of literature. J Med Cases. 2020;11(11):362-5. https://doi.org/10.14740/ jmc3575
21. Restrepo HF, Lara CG, Alvarez MM. Disseminated cryptococcosis in a positive patient for COVID-19 [Spanish]. Revista Repertorio de Medicina y Cirugía. 2021;:46-50. https://doi.org/10.31260/ RepertMedCir.01217372.1209
22. Limper AH. The changing spectrum of fungal infections in pulmonary and critical care practice: clinical approach to diagnosis. Proc Am Thorac Soc.2010; 7: 163-168. https://doi. org/10.1513/pats.200906-049AL
23. Song KD, Lee KS, Chung MP, et al. Pulmonary cryptococcosis: imaging findings in 23 non-AIDS patients. Korean J Radiol. 2010;11(4):407-416. https://doi.org/10.3348/kjr.2010.11.4.407
24. Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clinical Infectious Diseases. 2020;71(15):762-8. https://doi.org/10.1093/cid/ciaa248
25. Liu J, Li S, Liu J, Liang B, Wang X, Li W, et al. Longitudinal Characteristics of Lymphocyte Responses and Cytokine Profiles in the Peripheral Blood of SARS-CoV-2 Infected Patients. SSRN Electronic Journal. 2020; 55. https://doi.org/10.2139/ ssrn.3539682
26. Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. Journal of Clinical Investigation. 2020;130(5):2620-9. https://doi.org/10.1172/JCI137244
27. Brown MJ, Alazawi W, Kanoni S. Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19. N Engl J Med. 2021 Sep 16;385(12):1147. https://doi.org/10.1056/ NEJMc2108482
28. Recovery Collaborative Group. Tocilizumab in patients admitted to controlled, open-label, platform trial. Lancet. 2021;397(10285):1637- 1645. https://doi.org/10.1101/2021.02.11.21249258
29. Pettit NN, Nguyen CT, Mutlu GM, Wu D, Kimmig L, Pitrak D, et al. Late Onset Infectious Complications and Safety Of Tocilizumab In The Management of COVID-19. Journal of Medical Virology. 2020;93(3):1459-64. https://doi.org/10.1002/jmv.26429
| Files | ||
| Issue | Vol 7 No 5 (2022): September-October | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v7i5.11859 | |
| Keywords | ||
| Pulmonary cryptococcosis Cryptococcus laurentii non-neoformans Cryptococcus pulmonary mycosis COVID-19 SARS-CoV-2. | ||
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How to Cite
1.
Duran Luciano P. Non-Neoformans Pulmonary Cryptococcosis Due to Cryptococcus Laurentii in a Positive SARS-COV-2 Patient. CRCP. 2023;7(5):221-226.
