A 64-year-old man with idiopathic CD4(+) lymphocytopenia developed cognitive impairment and gait ataxia with isolated obstructive hydrocephalus, which was fatal. Cerebrospinal fluid showed mild pleocytosis, but the etiology was not revealed by extensive analysis. At autopsy, inflammatory cells, CD8(+) lymphocytes and abundant macrophages but not CD4(+) lymphocytes were infiltrating the meninges at the base of the brain. Electron microscopy demonstrated that inflammation was caused by Cryptococcus neoformans, which was localized exclusively within macrophages, where it grew with budding. Our study suggests that, in idiopathic CD4(+) lymphocytopenia, macrophages can efficiently phagocytize but inefficiently digest C. neoformans, thus representing a vehicle of chronic intracellular infection.

Sancesario, G., Palmieri, G., Viola, G., Fontana, C., Perfetti, A., Anemona, L., et al. (2011). Difficulty diagnosing chronic cryptococcal meningitis in idiopathic CD4+ lymphocytopenia. NEUROLOGICAL SCIENCES, 32(3), 519-524 [10.1007/s10072-011-0496-5].

Difficulty diagnosing chronic cryptococcal meningitis in idiopathic CD4+ lymphocytopenia

SANCESARIO, GIUSEPPE;PALMIERI, GIAMPIERO;FONTANA, CARLA;ANEMONA, LUCIA;FLORIS, ROBERTO;BERNARDI, GIORGIO;SPAGNOLI, LUIGI GIUSTO
2011-01-01

Abstract

A 64-year-old man with idiopathic CD4(+) lymphocytopenia developed cognitive impairment and gait ataxia with isolated obstructive hydrocephalus, which was fatal. Cerebrospinal fluid showed mild pleocytosis, but the etiology was not revealed by extensive analysis. At autopsy, inflammatory cells, CD8(+) lymphocytes and abundant macrophages but not CD4(+) lymphocytes were infiltrating the meninges at the base of the brain. Electron microscopy demonstrated that inflammation was caused by Cryptococcus neoformans, which was localized exclusively within macrophages, where it grew with budding. Our study suggests that, in idiopathic CD4(+) lymphocytopenia, macrophages can efficiently phagocytize but inefficiently digest C. neoformans, thus representing a vehicle of chronic intracellular infection.
2011
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA
English
Con Impact Factor ISI
Fatal Outcome; Diagnosis, Differential; Cryptococcus neoformans; Humans; T-Lymphocytopenia, Idiopathic CD4-Positive; Meningitis, Cryptococcal; Middle Aged; Chronic Disease; Hydrocephalus; Male
Sancesario, G., Palmieri, G., Viola, G., Fontana, C., Perfetti, A., Anemona, L., et al. (2011). Difficulty diagnosing chronic cryptococcal meningitis in idiopathic CD4+ lymphocytopenia. NEUROLOGICAL SCIENCES, 32(3), 519-524 [10.1007/s10072-011-0496-5].
Sancesario, G; Palmieri, G; Viola, G; Fontana, C; Perfetti, A; Anemona, L; Floris, R; Marziali, S; Bernardi, G; Spagnoli, Lg
Articolo su rivista
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/51953
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