Advanced Biomedical Research

HIV infection presenting as bone marrow cryptococcosis

Authors

Department of Pathology, Pad Dr DY Patil Medical College, Pune, Maharashtra, India

Abstract

Disseminated cryptococcal infection is an uncommon initial manifestation in immunocompromised patients. We report a rare case of a 40-year-old female presenting with fever and burning epigastrium. Peripheral blood film revealed a leukoerythroblastic picture with thrombocytopenia. Bone marrow aspiration showed granulomas along with cryptococcal yeast forms. The ELISA test for detection of human immunodeficiency virus (HIV) antigen was positive. Disseminated cryptococcosis can develop as the first manifestation of HIV infection in previously healthy individuals and granulomas in such bone marrow aspiration smears are a valuable clue to an underlying opportunistic infection.

Keywords

1. Bodem CR, Hamory BH, Taylor HM, Kleopfer L. Granulomatous bone marrow disease. A review of the literature and clinicopathologic analysis of 58 cases. Medicine (Baltimore) 1983;62:372-83.  Back to cited text no. 1
    
2. Diebold J, Molina T, Camilleri-Broet S, leTourneau A, Audouin J. Bone marrow manifestations of infectious and systemic diseases observed in bone marrow trephine biopsy. Histopathology 2000;37:199-211.  Back to cited text no. 2
    
3. Witt D, McKay D, Schwam L, Goldstein D, Gold J. Acquired immune deficiency syndrome presenting as bone marrow and mediastinal cryptococcosis. Am J Med 1987;82:149-50.  Back to cited text no. 3
    
4. Wong KF, Ma SK, Chan JK, Lam KW. Acquired immunodeficiency syndrome presenting as marrow cryptococcosis. Am J Hematol 2006;42:392-4.  Back to cited text no. 4
    
5. Malhotra P, Chauhan S, Bhatt P, Varma N, Chakrabarti A. Cryptococcal meningitis in acute lymphoblastic leukemia. J Assoc Physicians India 2004;52:831-2.  Back to cited text no. 5
    
6. Patricia M. Spencer and George Gee Jackson. Fungal and mycobacterial infections in patients infected with the human immunodeficiency virus. J Anti-microb Chemother 1989;23:107-25.  Back to cited text no. 6
    
7. Chakrabarti A, Jatana M, Kumar P. Isolation of cryptococcus neoformans var gatti from eucalyptus camaldulensis. Indian J Clin Microbiol 1997;35:3440-2.  Back to cited text no. 7
    
8. Lazera Cavalcanti MA, Trilles L, Nishikawa MM. Cryptococcus neoformans var gatti- evidence for a natural habitat related to decaying wood in a pottery tree hollow. Med Mycol 1998;36:119-22.  Back to cited text no. 8
    
9. Taneja J, Bhargava A, Loomba P, Dogra V, Thakur A, Mishra B. Cryptococcal granulomas in an immunocompromised HIV-negative patient. Indian J Pathol Microbiol 2008;51:553-5.  Back to cited text no. 9
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10. Pantanowitz L, Omar T, Sonnendecker H, Karstaedt AS. Bone marrow cryptococcal infection in the acquired immunodeficiency syndrome. J Infect 2000;41:92-4.  Back to cited text no. 10
    
11. Zinck SE, Leung AN, Frost M, Berry GJ, Müller NL. Pulmonary cryptococcosis: CT and pathologic findings. J Comput Assist Tomog 2002;3:330-4.  Back to cited text no. 11
    
12. Patz EF Jr, Goodman PC. Pulmonary cryptococcosis. J Thorac Imaging 1992;7:51-5.  Back to cited text no. 12
Advanced Biomedical Research
Volume 2014, june
June 2014
Pages 1-3