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KMID : 0338420140290030370
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The Korean Journal of Internal Medicine
2014 Volume.29 No. 3 p.370 ~ p.374
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Cryptococcal meningitis in a patient with chronic hepatitis C treated with pegylated-interferon and ribavirin
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Lee Tae-Hee
Lee Kee-Ook
Kim Yong-Seok
Kim Sun-Moon
Huh Kyu-Chan
Choi Young-Woo
Kang Young-Woo
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Abstract
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Various adverse events have been reported during combination therapy with pegylated (PEG)-interferon-α 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/mm3, 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-α and ribavirin.
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KEYWORD
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Cryptococcus, Meningitis, PEG-interferon-α, Ribavirin, Hepatitis C
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