Annals of Clinical Microbiology, The official Journal of the Korean Society of Clinical Microbiology

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pISSN 2288-0585 eISSN 2288-6850

Two Cases of Cryptococcuria Developed as Isolated Cryptococcuria and Disseminated Cryptococcosis

Case report

Annals of Clinical Microbiology (Ann Clin Microbiol) 2011 December, Volume 14, Issue 4, pages 148-152.

https://doi.org/10.5145/ACM.2011.14.4.148

Two Cases of Cryptococcuria Developed as Isolated Cryptococcuria and Disseminated Cryptococcosis

Mi Hyun Bae1, Seung Namgoong1, Dongheui An1, Mi-Na Kim1, Sung-Han Kim2, Ki-Ho Park2, Sung-Gyu Lee3
1Department of Laboratory Medicine, 2Division of Infectious Diseases, and 3Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

Abstract

Cryptococcus is an opportunistic pathogen that mainly affects immunocompromised hosts and, less frequently, immunocompetent hosts. It causes serious morbidity and mortality due to systemic infections such as meningoencephalitis and pulmonary infection. Urinary involvement of Cryptococcus is sometimes reported among cases of disseminated cryptococcosis in AIDS patients, but no such reports have been published in Korea. We report two cases of cryptococcuria that developed in a 71-year old female with diabetes and liver cirrhosis and in a 50-year old male who received a liver transplant due to HBV-associated hepatic failure. The female patient had received prednisolone for 12 days before we detected C. neoformans in urine culture. Even though no antifungal therapy was indicated for cryptococcuria, following urine culture became negative, but still positive for cryptococcal antigen on hospital day 25. Her blood, CSF culture, and antigen tests were negative, and therefore she was diagnosed with isolated cryptococcuria. The male patient had received prednisolone and tacrolimus for 10 days before sputum and urine cultures became positive for C. neoformans. He had ill defined nodules and pleural effusion in both lungs on chest CT. His cryptococcuria was sustained for over 2 months, despite receiving amphotericin B treatment. His cryptococcuria seemed to be a symptom of disseminated cryptococcosis. (Korean J Clin Microbiol 2011;14:148-152)

Keywords

Cryptococcus neoformans, Cryptococcuria, Urine, Culture