Progressive Cytopenia Developing during Treatment of Cryptococcosis in a Patient with HIV Infection and Bone Marrow Cryptococcal Infection
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- Katsura Mai
- AIDS Clinical Center of the National Center for Global Health and Medicine, Japan
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- Okuhama Ayako
- AIDS Clinical Center of the National Center for Global Health and Medicine, Japan
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- Koizumi Yoshiki
- AIDS Clinical Center of the National Center for Global Health and Medicine, Japan
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- Ando Naokatsu
- AIDS Clinical Center of the National Center for Global Health and Medicine, Japan
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- Yanagawa Yasuaki
- AIDS Clinical Center of the National Center for Global Health and Medicine, Japan
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- Mizushima Daisuke
- AIDS Clinical Center of the National Center for Global Health and Medicine, Japan
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- Aoki Takahiro
- AIDS Clinical Center of the National Center for Global Health and Medicine, Japan
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- Tsukada Kunihisa
- AIDS Clinical Center of the National Center for Global Health and Medicine, Japan
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- Teruya Katsuji
- AIDS Clinical Center of the National Center for Global Health and Medicine, Japan
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- Kikuchi Yoshimi
- AIDS Clinical Center of the National Center for Global Health and Medicine, Japan
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- Oka Shinichi
- AIDS Clinical Center of the National Center for Global Health and Medicine, Japan
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- Watanabe Koji
- AIDS Clinical Center of the National Center for Global Health and Medicine, Japan
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Abstract
<p>Cytopenia is a common complication in patients with human immunodeficiency virus (HIV) infection. Identifying the cause is demanding because of the wide range of possible diagnoses. We herein report an HIV-infected patient with disseminated cryptococcosis involving multiple organs including the blood, brain, lungs, and bone marrow, who developed progressive pancytopenia after initiation of anti-fungal treatment with liposomal amphotericin-B (L-AMB) and flucytosine (5FC). The pancytopenia persisted despite early 5FC discontinuation. A bone marrow biopsy revealed cryptococcal infiltration and the blood examination findings recovered quickly after resuming L-AMB. Thus, this HIV-infected patient's pathological findings and clinical course suggested that the primary cause of the pancytopenia was bone marrow cryptococcosis. </p>
Journal
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- Internal Medicine
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Internal Medicine 61 (2), 257-261, 2022-01-15
The Japanese Society of Internal Medicine