Cryptococcal antigenemia in a Nigerian child with advanced HIV disease: a case report

Authors

  • Bassey E. Ekeng Department of Medical Microbiology and Parasitology, University of Calabar Teaching Hospital, Calabar, Nigeria
  • Grace I. Nwankwo Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
  • Olufunke F. Adedokun Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
  • Glory E. Bassey 2Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria; Department of Paediatrics, University of Calabar, Calabar, Nigeria
  • Christian Ide Department of Medical Microbiology and Parasitology, University of Calabar Teaching Hospital, Calabar, Nigeria
  • Linda N. Okorafor Department of Medical Microbiology and Parasitology, University of Calabar Teaching Hospital, Calabar, Nigeria
  • Kingsley A. Essien Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
  • Rita O. Oladele Department of Medical Microbiology and Parasitology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria

DOI:

https://doi.org/10.18203/2349-3291.ijcp20232257

Keywords:

Cryptococcal disease, AHD, Children

Abstract

Cryptococcal infection in Nigeria’s advanced HIV disease (AHD) population is not uncommon but is sparsely reported in children. The dearth of data on cryptococcal disease in our paediatric population suggests it is an uncommon clinical entity and may cause delayed diagnosis and preventable deaths. It is pertinent that cognizance be done of this clinical entity in our paediatric population. We report a 16-month-old HIV-positive child with complaints of weight loss of 3 months, cough of 1 month, fever, passage of watery stool, fast and difficulty in breathing for 1 week. She was initially managed as a case of paediatric AIDS with septicaemia and was receiving ceftriaxone and cotrimoxazole. The diagnosis was subsequently reviewed to paediatric AIDS with cryptococcal disease as the cryptococcal antigen screening test was positive and oral fluconazole commenced. However, the patient deteriorated and eventually died. This case report suggests a significant knowledge gap in the occurrence of cryptococcosis in our paediatric population and as a matter of urgency the need to conduct studies targeted at ascertaining the burden of cryptococcosis in children living with AHD in Nigeria.

References

WHO. Guidelines for diagnosing, preventing, and managing cryptococcal disease among adults, adolescents and children living with HIV. Geneva: WHO; 2022.

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Ekeng BE, Adams EB, Udoh UA, Ita OI, Okorafor LN, Monjol BE et al. Cryptococcus laurentii Fungaemia in a Neonate from Nigeria: A Case Report. JAMMR. 2022;34(23):379-83.

Muenchhoff M, Healy M, Singh R, Roider J, Groli A, Kindra C et al. Malnutrition in HIV-infected Children is an Indicator of Severe Disease with an Impaired Response to Antiretroviral Therapy. AIDS Res Hum Retroviruses. 2018;34(1):46-55.

Ekeng BE, Davies AA, Osaigbovo II, Warris A, Oladele RO, Denning DW. Pulmonary and Extrapulmonary Manifestations of Fungal Infections Misdiagnosed as Tuberculosis: The Need for Prompt Diagnosis and Management. JoF.2022;8:460.

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Published

2023-07-27

Issue

Section

Case Reports