Cough in Immunosuppressed Patients

Cryptococcus neoformans

A 22 year old man with HIV comes into the office complaining cough, shortness of breath, and fever. He also complains of pleuritic chest pain.

Labs: In spinal fluid with India ink, oval budding yeasts surrounded by wide polysaccharide capsule is present.

Discussion: Diagnosis of cryptococcosis is seen by culturing the organism from the spinal fluid and serologic tests. Cryptococcus neoformans usually manifests as meningitis. Pulmonary involvement is usually asymptomatic. In symptomatic patients, cough is the most common symptom. It is persistent severe and non-productive. Although it may cause symptoms in both immunocompetent and immunosuppressed patients, in AIDs patients, it is fatal.

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