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Cryptococcal meningitis and cerebral vasculitis in a patient with primary intestinal lymphangiectasia: a case report

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Abstract

Primary intestinal lymphangiectasia (Waldmann’s disease) is a rare exudative enteropathy without precisely assessed infectious risk. We report the case of a 49-year-old male patient with meningitis and cerebral vasculitis due to Cryptococcus neoformans complicating Waldmann’s disease diagnosed 12 years ago. The treatment combined liposomal amphotericin B, 3 mg/kg daily plus flucytosine 25 mg/kg/6 h, both intravenously during 15 days, then fluconazole 800 mg daily during 8 weeks, and finally 200 mg daily indefinitely. Dexamethasone 0.4 mg/kg daily during the first week was gradually decreased over 2 months. The outcome was good, and the patient is still followed 3 years later without any recurrence.

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Acknowledgements

We acknowledge Marie Desnos-Ollivier and Françoise Dromer (National Reference Center for invasive mycoses and Antifungals; Pasteur Institute, Paris, France) for the identification and MICs (in the context of the RESSIF surveillance network) from the patient’s isolate.

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Authors and Affiliations

  1. Department of Infectious Diseases, Hôpital Lariboisière, Saint-Louis-Lariboisière-Fernand Widal Hospitals, AP-HP, 2 Rue Ambroise Paré, 75010, Paris, France

    Martin Mathurin, Sandra Devatine, Aude Kopp-Derouet, Victoria Manda, Véronique Delcey, Jean-Michel Molina & Pierre Sellier

  2. Department of Neuroradiology, Lariboisière-Fernand Widal Hospitals, AP-HP, Paris, France

    Antoine Guillonnet

  3. Laboratoire de Parasitologie-Mycologie, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France

    Alexandre Alanio

  4. Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives Et Antifongiques, CNRS UMR2000, Institut Pasteur, Paris, France

    Alexandre Alanio

  5. Department of Gastroenterology, Assistance Publique-Hôpitaux de Paris, Saint-Louis- Lariboisière-Fernand Widal Hospitals, Paris, France

    Nelson Lourenco

Authors
  1. Martin Mathurin
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  2. Sandra Devatine
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  3. Aude Kopp-Derouet
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  4. Antoine Guillonnet
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  5. Alexandre Alanio
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  6. Nelson Lourenco
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  7. Victoria Manda
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  8. Véronique Delcey
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  9. Jean-Michel Molina
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  10. Pierre Sellier
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Corresponding authors

Correspondence to Martin Mathurin or Pierre Sellier.

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The patient gave his informed, written consent about the writing and publication of this case report and for the use of the radiographic images.

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The authors declare no competing interests.

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Mathurin, M., Devatine, S., Kopp-Derouet, A. et al. Cryptococcal meningitis and cerebral vasculitis in a patient with primary intestinal lymphangiectasia: a case report. Eur J Clin Microbiol Infect Dis 42, 1263–1267 (2023). https://doi.org/10.1007/s10096-023-04657-y

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  • DOI: https://doi.org/10.1007/s10096-023-04657-y

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