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Cryptococcus in the Urine: We may not See it But it is Frequently there. | OMICS International
ISSN: 2165-7920
Journal of Clinical Case Reports
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Cryptococcus in the Urine: We may not See it But it is Frequently there.

Jose Antonio Tesser Polonia1*, Liane N. Rotta2 and Alessandro C Pasqualottoa1
1Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
2Universidade Federal de Ciencias da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
Corresponding Author : Jose Antonio Tesser Poloni
Rua Riveira 280/803, Porto Alegre–RS
90670-160, Brazil
Tel: +55-51-99689730
Fax: +55-51-32148090
E-mail: [email protected]
Received April 18, 2015; Accepted April 20, 2015; Published April 22, 2015
Citation: Polonia JAT, Rotta LN, Pasqualottoa AC (2015) Cryptococcus in the Urine: We may not See it But it is Frequently there. J Clin Case Rep 5:i108. doi:10.4172/2165-7920.1000i108
Copyright: © 2015 Polonia JAT, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

A 57-year-old man kidney transplant recipient was admitted to the hospital for severe headache and respiratory symptoms. During routine urinalysis, yeasts were seen in the urine sediment and these were regarded as probable Candida species. Since the laboratory was informed by the attending clinician that the patient was immunosuppressed, urine was stained with China ink and revealed the presence of budding yeast-like capsular organisms, consistent with Cryptococcus sp.

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A 57-year-old man kidney transplant recipient was admitted to the hospital for severe headache and respiratory symptoms. During routine urinalysis, yeasts were seen in the urine sediment and these were regarded as probable Candida species. Since the laboratory was informed by the attending clinician that the patient was immunosuppressed, urine was stained with China ink and revealed the presence of budding yeast-like capsular organisms, consistent with Cryptococcus sp. (Figure 1). Cryptococcosis was latter confirmed by serum latex (titer >1:10,000) and by positive fungal culture in the cerebrospinal fluid.
The patient was treated with IV amphotericin B and had a good clinical response. Even though Cryptococcus sp. can be frequently recovered from the urine (urine sediment analysis can be a decoy), most laboratories will not investigate for the presence of Cryptococcus unless they are requested to.
Performing China Ink in routine laboratories dealing with samples from immunocompromised patients could allow for an early diagnosis of disseminated cryptococcosis. This is a fast and low-cost procedure, allowing for the fungal visualization within 1-2 minutes.

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