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Journal : Academic Hospital Journal

Pulmonary Cryptococcosis due to Cryptococcus laurentii Co-infection with Miliary Tuberculosis in Adolescent Patient in Indonesia: Case Report Widyasari, Domas Fitria; Daniwijaya, M Edwin Widyanto; Siswanto, Siswanto; Wirastuti, Fita; Wibawa, Tri
Academic Hospital Journal Vol 7, No 2 (2025)
Publisher : Rumah Sakit Akademik Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ahj.v7i2.110936

Abstract

AbstractBackground: Non-neoformans cryptococci were previously considered to be saprophytes and nonpathogenic to humans. Cryptococcus laurentii is commonly found in the environment and pigeon feces and has been reported to be an emerging human fungal pathogen that causes infection in the immunocompromised host. Here, we report a unique case of pulmonary cryptococcosis coinfection with Miliary Tuberculosis.Case: A 14-years old adolescent underweight boy was admitted to the Emergency Unit with the chief complaint of fever, cough, chest pain, breathlessness, night sweats, malaise, and weight loss. He was referred from Public Health Center in Sleman Yogyakarta with Miliary Tuberculosis and consumed six weeks of fixed-dose combinations of the first-line anti-tuberculosis drug. Microbiology culture of good quality patient sputum revealed Cryptococcus laurentii along with Klebsiella oxytoca. The patient was diagnosed with Pulmonary Cryptococcosis. The patient's symptoms, especially fever and chest pain, were not improved by oral Fluconazole 200 mg treatment. However, he had an excellent response to Levofloxacin 500 mg during hospitalization and oral Fluconazole therapy at 400 mg/day for eight weeks. After eight weeks of Fluconazole treatment, the patient got well, and then Fluconazole was stopped. Anti-tuberculosis was treated for six months, and no recurrence was found.Conclusion: This article reports the rare pulmonary involvement of Cryptococcus laurentii in adolescent patients with Miliary Tuberculosis patient in Indonesia. A high degree of pulmonary mycosis suspicion and techniques improvement for respiratory specimen collection, culture, and identification contribute to early diagnosis and fungal infection treatment. In addition, interprofessional discussion can improve patient treatment and outcomes. 
Co-Authors Abdul Rahman Siregar Abdul Rahman Siregar, Abdul Rahman Abu Tholib Aman Adi Sofyan Ansori, Muhammad Ai Hertati, Ai Ali Wardana Anika Prastyowati, Anika Apon Zaenal Mustopa Arief Mulyono Arifah Khusnuryani Aris Haryanto Aris Haryanto Arum Sih Joharina Boy Bachtiar Cita Rosita Sigit Prakoeswa Daniwijaya, M Edwin Widyanto Diani Mentari Diptyanusa, Ajib Domas Fitria Widyasari Erni Martani Farahannisaa, Kintan Adelia Farida Dwi Handayani Farida J. Rachmawaty Farida J. Rachmawaty, Farida J. Febe, Ester Firdaus, Moh Egy Rahman Frutos, Roger Gunawan Gunawan Gunawan Madyono Putro Hakim, Mohamad Saifudin Hamidah, Berliana Hardyanto Soebono Haryanto, Darban Hayani Anastasia Hera Nirwati Huda Shalahudin Darusman I Kadek Mulyawan Ikramullah, Muh. Chaeril Intan Berlianty Irawan, Shasmita JAKA WIDADA Laksmi Wulandari Maguin, Sylvie Mahardika Agus Wijayanti Marsetyawan H.N.E. Soesatyo Marsetyawan H.N.E. Soesatyo, Marsetyawan H.N.E. Mirtani Naima Mubasysyir Hasanbasri Mulyawan, I Kadek Munawir Sazali Naima, Mirtani Nastiti Wijayanti Nastiti Wijayanti Nastiti Wijayanti Ning Rintiswati Ning Rintiswati Novriana, Riska Nurhaida Widiani Ova Emilia Pakpahan, Cennikon Pascawati, Nur Alvira Puteri, Rr. Astrid Aulia Artiono R.C. Hidayat Soesilohadi Rania Ayu Aziza Ratna, Lita Tri Rifqiyah Nur Umami, Rifqiyah Nur Riska Wulansari Ristiyanto Ristiyanto Roger Frutos S Siswanto S. Sutaryo Sadi Setyawan Budiharta Supargiono Supargiono Suratna, Suratna Sutaryo1 S, Sutaryo1 Sylvie Maguin Tri Baskoro Tunggul Satoto Tri Rini Nuringtyas Utomo, Humam Santosa Wardana, Ali Widya Asmara Wirastuti, Fita Wulansari, Riska Yati Soenarto Yundari, Yundari