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Cryptococcemia in an HIV-negative patient with decompensated liver cirrhosis.

Cryptococcemia in an HIV-negative patient with decompensated liver cirrhosis.
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Kandula M, Kelkar AH, Liberio N, Aiyer MK,


Kandula M, Kelkar AH, Liberio N, Aiyer MK, (click to view)

Kandula M, Kelkar AH, Liberio N, Aiyer MK,

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Journal of community hospital internal medicine perspectives 2016 12 156(6) 33383 doi 10.3402/jchimp.v6.33383

Abstract
BACKGROUND
Cryptococcal infections have been mostly associated with immunocompromised individuals, 80-90% of whom have been HIV-positive patients. Increasingly, cryptococcal infections are being reported in cirrhotic patients who are HIV-negative. The underlying immunologic defects in cirrhotic patients seem to play an important role in predisposing them to cryptococcosis and affecting their morbidity and mortality.

CASE PRESENTATION
We present a case of disseminated cryptococcosis in an HIV-negative patient with underlying cirrhosis, who had rapid worsening of his hyponatremia with renal failure and was unable to recover, despite aggressive measures.

CONCLUSION
Cryptococcus is a more common culprit of infections seen in cirrhotic patients than what it was previously known, and a high index of suspicion is required to diagnose these patients. Identification of poor prognostic factors, early diagnosis and intervention is crucial in the management of these patients.

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