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November 1986

Cryptococcal Meningitis in a Patient With Sickle Cell Anemia

Author Affiliations

Jamaica, NY

Arch Intern Med. 1986;146(11):2288-2289. doi:10.1001/archinte.1986.00360230234039

To the Editor.  —Patients with sickle cell disease are particularly susceptible to Salmonella bone infections, pneumococcal and Haemophilus influenzae septicemia, and meningitis.1 We recently cared for a patient with sickle cell disease and cryptococcal meningitis.

Report of a Case.  —A 42-year-old black man with sickle cell anemia was hospitalized for lethargy and change in mental status of several days' duration. He had a history of leg ulcers, osteomyelitis, and gallstones. He was hallucinating, felt restless and disoriented, and had icteric sclerae and a temperature of 38.6°C. The result of his cerebrospinal fluid india ink preparation analysis was positive, and Cryptococcus neoformans was subsequently cultured from that fluid. Despite treatment with amphotericin B and supportive measures, the patient's condition deteriorated and he died within 48 hours.

Comment.  —Cryptococcal infections are common in patients with the acquired immunodeficiency syndrome (AIDS).2 Our patient had no evidence of AIDS and results of