Vol.21 No.3

Case Report

Concurrent presentation of cryptococcal meningoencephalitis and systemic lupus erythematosus

Authors

Masami Matsumura1 , Rika Kawamura2 , Ryo Inoue2 , Kazunori Yamada2 , Mitsuhiro Kawano2 , Masakazu Yamagishi3

  • Research Center for Medical Education, Kanazawa University Graduate School of Medicine, Takara-machi 13-1, Kanazawa Ishikawa, 920-8641, Japan
  • Division of Rheumatology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
  • Division of Cardiology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
Received:

27 August 2010

Accepted:

1 November 2010

Published online:

29 December 2010

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Abstract

Cryptococcal meningitis is a recognized complication of systemic lupus erythematosus (SLE), with high mortality rates, particularly in those treated with immunosuppressive agents. We describe a patient diagnosed simultaneously with cryptococcal meningoencephalitis and SLE and reviewed four similar cases reported in the literature. In our case, profound low CD4 lymphocyte count and low complement levels were observed. The patient was treated with prednisolone, fluconazole, and 5-flucytosine and evinced good clinical improvement. This case suggests that intrinsic immunological abnormality related to SLE predisposed to opportunistic infections.

Key words

Cryptococcal meningoencephalitis - Intrinsic immunological abnormality - Systemic lupus erythematosus