Pulmonary cryptococcosis misdiagnosed as smear-negative pulmonary tuberculosis with fatal consequences.

Jarvis, Joseph N; Wainwright, Helen; Harrison, Thomas S; Rebe, Kevin; Meintjes, Graeme; (2010) Pulmonary cryptococcosis misdiagnosed as smear-negative pulmonary tuberculosis with fatal consequences. International journal of infectious diseases, 14 Sup (SUPPL.). e310-e312. ISSN 1201-9712 DOI: https://doi.org/10.1016/j.ijid.2010.02.2255

Abstract

HIV-associated pulmonary cryptococcosis is under diagnosed, and may progress to fatal meningoencephalitis. We present a case of HIV-associated pulmonary Cryptococcus neoformans infection, initially mis-diagnosed as smear-negative pulmonary TB, which progressed to fatal cryptococcal meningitis. Autopsy series suggest that pulmonary cryptococcosis is common in African AIDS patients, and, due to limited diagnostic capacity, often mis-diagnosed as smear negative TB. Serum cryptococcal antigen testing may facilitate diagnosis in such cases.