Placental Cryptococcosis in an HIV Infected Woman with Eclampsia: A Rare Case Report
DOI:
https://doi.org/10.21276/apalm.3139Keywords:
Placenta, Cryptococcus neoformans, HIVAbstract
Cryptococcosis is not uncommon, especially among immunocompromised patients. However, placental cryptococcosis is rare, with few reported cases in the literature. A 21 yr. old primigravida, a known case of HIV was admitted to hospital at 36 weeks gestation for antepartum hemorrhage. Her vital signs were within normal limits. Her laboratory investigations revealed hemoglobin-6 gm%. The peripheral smear showed microcytic hypochromic anemia. Urine showed traces of albumin. On the sixth day of admission, she developed features of eclampsia and delivered a male baby of birth weight 1700 gm. The placenta weighed 350 gm. Microscopy of placenta showed marked perivillous fibrin deposits, decidual arteriopathy and syncytial knots. At places, cryptococci were seen which showed thick capsule around them. A diagnosis of placental cryptococcosis with features of eclampsia was made. On the third day postpartum, she developed drowsiness and disorientation. CSF analysis was suggestive of cryptococcal meningitis. On the fifth day postpartum, patient died of DIC and multiorgan failure. It is important to establish the involvement of placenta by the opportunistic infections like Cryptococcus neoformans in immunocompromised women, so that the baby and the mother can be instituted with immediate appropriate management.
References
Darko AD, Dim DC, Taylor G, Watson DC, Sun CC. Placental cryptococcus neoformans infection without neonatal disease: a case report and review of the literature. Pediatr Dev Pathol. 2009; 12(3): 249-252
Pastagia M, Caplivski D. Disseminated cryptococcosis resulting in a miscarriage in a woman without other immunocompromise: a case report. Int J Infect Dis. 2010 May;14(5):e441-3
Guilarde AO, Andrade ACA, De Sousa MA, De Oliveira AM, Sugita DM. Placental and pulmonary cryptococcosis associated with fungemia in patient with acquired immunodeficiency syndrome. Infez Med. 2019; 27(2):187-189
Silberfarb PM, Sarosi GA, Tosh FE. Cryptococcosis and pregnancy. Am J Obstet Gynecol. 1972 Mar;112(5):714-20
Gonzalez LA, Vasquez G, Restrepo JP, Velasquez M, Ramirez LA. Cryptococcosis in systemic lupus erythematosus: a series of six cases. Lupus. 2010; 19(5): 639-645
Castro G, Cervi MC, Martinez R. Vertical transmission of Cryptococcus neoformans from a mother coinfected with human immunodeficiency virus. Case report. Rev Soc Bras Med Trop 2006; 39(5): 501-503
Ellenson LH, Pirog EC. The Female genital tract. In: Kumar V, Abbas AK, Aster JC. Robbins and Cotran Pathologic basis of Disease. 9th edition. Vol II. New Delhi: RELX India Private limited; 2016.p1037-39
Kida M, Abramowsky CR, Santoscoy C. Cryptococcosis of the placenta in a woman with acquired immunodeficiency syndrome. Hum Pathol 1989;20:920-21.
Patel M, Beckerman KP, Reznik S, Madanand RP, Goldman DL. Transplacental transmission of Cryptococcus neoformans to an HIV-exposed premature neonate. J Perinatol 2012;235-37.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Shruthi A, Meena N Jadhav, S K Kittur, K S Lakshmi
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
