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Cryptococcal meningitis in a patient with chronic hepatitis C treated with pegylated-interferon and ribavirin

  • Lee, Tae-Hee (Department of Internal Medicine, Konyang University College of Medicine) ;
  • Lee, Kee-Ook (Department of Neurology, Konyang University College of Medicine) ;
  • Kim, Yong-Seok (Department of Internal Medicine, Konyang University College of Medicine) ;
  • Kim, Sun-Moon (Department of Internal Medicine, Konyang University College of Medicine) ;
  • Huh, Kyu-Chan (Department of Internal Medicine, Konyang University College of Medicine) ;
  • Choi, Young-Woo (Department of Internal Medicine, Konyang University College of Medicine) ;
  • Kang, Young-Woo (Department of Internal Medicine, Konyang University College of Medicine)
  • Received : 2012.02.17
  • Accepted : 2012.08.06
  • Published : 2014.05.01

Abstract

Various adverse events have been reported during combination therapy with pegylated (PEG)-interferon-$\alpha$ and ribavirin, although opportunistic infections, especially cryptococcal meningitis, are very rare. A 61-year-old woman complained of headaches and a fever during treatment of a chronic hepatitis C virus (HCV) infection. She had been treated for 7 months. Her headaches were refractory to analgesics, and she developed subtle nuchal rigidity. The cerebral spinal fluid (CSF) revealed a white blood cell count of $205/mm^3$, 51 mg/dL protein, 35 mg/dL glucose, and negative Cryptococcus antigen. The CSF culture resulted in no growth. Five days later, the CSF was positive for Cryptococcus antigen. We administered amphotericin B and flucytosine, followed by fluconazole. Approximately 2 months later, she was discharged. For the first time, we report a case of cryptococcal meningitis during the treatment of chronic HCV with PEG-interferon-$\alpha$ and ribavirin.

Keywords

References

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Cited by

  1. Peginterferon-α-2b/ribavirin : Cryptococcal meningitis: case report vol.1507, pp.1, 2014, https://doi.org/10.1007/s40278-014-1603-1