Demencia rápidamente progresiva por meningitis criptocócica: Reporte de caso
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Las demencias constituyen un grupo de enfermedades degenerativas que afectan diversos dominios dentro de la cognición humana. Si bien el curso habitual es crónico y progresivo, una proporción de pacientes desarrollan un deterioro subagudo en meses, formando una entidad denominada demencia rápidamente progresiva. Es necesario realizar un abordaje basado en la búsqueda activa de etiologías reversible, y su diagnóstico debe tenerse en cuenta no solo en pacientes inmunocomprometidos por el virus de la inmunodeficiencia humana, sino también en pacientes con otra causa de inmunosupresión. En el presente artículo reportamos el caso de un paciente inmunocomprometido por uso de corticoides que desarrolló una demencia rápidamente progresiva como la manifestación de una meningoencefalitis criptocócica.
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American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th edition. Ed. Arlington, Virginia, United States of America: American Psychiatric Publishing; 2013. pp. 596-635.
https://doi.org/10.1176/appi.books.9780890425596
www.who.org [Internet]. Dementia. World Health Organization; c2022 [cited 2022 Jan 23]. Available from: https://www.who.int/news-room/factsheets/detail/dementia.
Arvanitakis Z, Shah R, Bennett, D. Diagnosis and Management of Dementia: Review. JAMA. 2019;322(16):1589-1596. doi:10.1001/jama.2019.4782.
https://doi.org/10.1001/jama.2019.4782
Geschwind MD. Rapidly Progressive Dementia. Continuum (Minneap Minn).2016;22(2 Dementia):510-537. doi: 10.1212/CON.0000000000000319.
https://doi.org/10.1212/CON.0000000000000319
Gogia B, Fang X. Differentiating Delirium Versus Dementia in the Elderly. 2021. [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. PMID: 34033356.
Studart Neto A, Soares Neto HR, Simabukuro MM, et al. Rapidly Progressive Dementia: Prevalence and Causes in a Neurologic Unit of a Tertiary Hospital in Brazil. Alzheimer Dis Assoc Disord. 2017;31(3):239- 243. doi: 10.1097/WAD.0000000000000170.
https://doi.org/10.1097/WAD.0000000000000170
Anuja P, Venugopalan V, Darakhshan N, et al. Rapidly progressive dementia: An eight year (2008-2016) retrospective study. PLoS One. 2018;13(1):1-13. doi: 10.1371/journal.pone.0189832.
https://doi.org/10.1371/journal.pone.0189832
Xia S, Li X, Li H. Imaging characterization of cryptococcal meningoencephalitis. Radiol Infect Dis. 2016;3(4):187-191. https://doi.org/10.1016/j.jrid.2016.05.003.
https://doi.org/10.1016/j.jrid.2016.05.003
Buchanan KL, Murphy JW. What Makes Cryptococcus neoformans a Pathogen?. Emerging Infectious Diseases. 1998;4(1):71-83. doi:10.3201/eid0401.980109.
https://doi.org/10.3201/eid0401.980109
Marr KA, Sun Y, Spec A, et al. A multicenter, longitudinal cohort study of cryptococcosis in human immunodeficiency virus-negative people in the United States. Clin Infect Dis. 2020;70(2):252-261. doi: 10.1093/cid/ciz193.
https://doi.org/10.1093/cid/ciz193
Park BJ, Wannemuehler KA, Marston BJ, Govender N, Pappas PG, Chiller TM. Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS. AIDS. 2009;23(4):525-530. doi: 10.1097/QAD.0b013e328322ffac.
https://doi.org/10.1097/QAD.0b013e328322ffac
Williamson PR, Jarvis JN, Panackal AA, et al. Cryptococcal meningitis: Epidemiology, immunology, diagnosis and therapy. Nature Reviews Neurology. Nat Rev Neurol. 2016. 13(1):13-24. doi: 10.1038/ nrneurol.2016.167
https://doi.org/10.1038/nrneurol.2016.167
Deb S, Walterfang M, Varghese D. Cryptococcal dementia in a patient with sarcoidosis. Med J Aust. 2006 ;184(2):86-87. doi: 10.5694/j.1326-5377.2006.tb00126.x.
https://doi.org/10.5694/j.1326-5377.2006.tb00126.x
Seto H, Nishimura M, Minamiji K, et al. Disseminated cryptococcosis in a 63-year-old patient with multiple sclerosis treated with fingolimod. Intern Med. 2016 Nov 15;55(22):3383-3386. doi: 10.2169/internalmedicine.55.7255.
https://doi.org/10.2169/internalmedicine.55.7255
Yamashiro N, Nagasaka T, Takaki R, Miwa M, Shindo K, Takiyama Y. A case of cryptococcal ventriculitis with slowly progressive gait disturbance and memory impairment as initial symptoms. Clin Neurol. 2015;55(2):81-86. doi: 10.5692/clinicalneurol.55.81.
https://doi.org/10.5692/clinicalneurol.55.81
Kashef Hamadani BH, Franco-Paredes C, McCollister B, Shapiro L, Beckham JD, Henao-Martínez AF. Cryptococcosis and cryptococcal meningitis: new predictors and clinical outcomes at a United States academic medical centre. Mycoses. 2018;61(5):314-320. doi.org/10.1111/myc.12742.
https://doi.org/10.1111/myc.12742
Ala TA, Doss RC, Sullivan CJ. Reversible dementia: A case of cryptococcal meningitis masquerading as Alzheimer's disease. J Alzheimer's Dis. 2004;6(5):503-508. doi: 10.3233/jad-2004-6507.
https://doi.org/10.3233/JAD-2004-6507
Knopman DS, DeKosky ST, Cummings JL, et al. Practice parameter: diagnosis of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001;56(9):1143-53. doi: 10.1212/wnl.56.9.1143.
https://doi.org/10.1212/WNL.56.9.1143
Aharon-Peretz J, Kliot D, Finkelstein R, Ben Hayun R, Yarnitsky D, Goldsher D. Cryptococcal meningitis mimicking vascular dementia. Neurology. 2004;62(11):2135. doi: 10.1212/01.wnl.0000127626.69822.67.
https://doi.org/10.1212/01.WNL.0000127626.69822.67
Hoffmann M, Muniz J, Carroll E, De Villasante J. Cryptococcal meningitis misdiagnosed as Alzheimer's disease: complete neurological and cognitive recovery with treatment. J Alzheimers Dis. 2009;16(3):517-20. doi: 10.3233/JAD-2009-0985.
https://doi.org/10.3233/JAD-2009-0985
Chen CH, Chang CC, Chang WN, et al. Neuro-psychological sequelae in HIV-negative cryptococcal meningitis after complete anti-fungal treatment. Acta Neurol Taiwan. 2012;21(1):8-17.
Brizendine KD, Baddley JW, Pappas PG. Predictors of mortality and differences in clinical features among patients with Cryptococcosis according to immune status. PLoS One. 2013;8(3):e60431. doi: 10.1371/ journal.pone.0060431.
https://doi.org/10.1371/journal.pone.0060431
Steiner I, Polacheck I, Melamed E. Dementia and myoclonus in a case of cryptococcal encephalitis. Arch Neurol. 1984;41(2):216-217. doi: 10.1001/ archneur.1984.04050140118040.
https://doi.org/10.1001/archneur.1984.04050140118040
Sa'adah MA, Araj GF, Diab SM, Nazzal M. Cryptococcal meningitis and confusional psychosis. A case report and literature review. Trop Geogr Med. 1995;47(5):224-226.
Park MK, Hospenthal DR, Bennett JE. Treatment of hydrocephalus secondary to cryptococcal meningitis by use of shunting. Clin Infect Dis. 1999;28(3):629-633. doi: 10.1086/515161.
https://doi.org/10.1086/515161
Kovoor JME, Mahadevan A, Narayan JP, et al. Cryptococcal choroid plexitis as a mass lesion: MR imaging and histopathologic correlation. Am J Neuroradiol. 2002;23(2):273-6.
Tang WK, Hui M, Ungvari GS, Leung CM. Cryptococcal meningitis mimicking primary mania in a young female. Gen Hosp Psychiatry. 2005;27(4):301-303. doi: 10.1016/j.genhosppsych.2005.03.003.
https://doi.org/10.1016/j.genhosppsych.2005.03.003
Prakash PY, Sugandhi RP. Neuropsychiatric manifestation of confusional psychosis due to Cryptococcus neoformans var. grubii in an apparently immunocompetent host: a case report. Cases J. 2009;2(1):1-3. doi: 10.1186/1757-1626-2-9084.
https://doi.org/10.1186/1757-1626-2-9084
Kumar A, Gopinath S, Dinesh KR, Karim S. Infectious psychosis: cryptococcal meningitis presenting as a neuropsychiatry disorder. Neurol India. 2011;59(6):909-911. doi: 10.4103/0028-3886.91379.
https://doi.org/10.4103/0028-3886.91379
Greenlee JE. Cryptococcal encephalopathy without persisting cerebrospinal fluid pleocytosis, a diagnostic challenge: case report and review of the literature. Clin Neurol Neurosurg. 2013;115(9):1897-1899. doi: 10.1016/j.clineuro.2013.05.005.
https://doi.org/10.1016/j.clineuro.2013.05.005
Ogura R, Yoshimura J, Sano M, et al. Entrapment of the inferior horns of the lateral ventricle with enlargement of the bilateral choroid plexus. Neuropathology. 2014;34(2):210-213. doi: 10.1111/neup.12072.
https://doi.org/10.1111/neup.12072
Ikumi K, Yokoi K, Ando T. [Cryptococcal meningoencephalitis presenting with treatable cognitive impairment and involuntary movement]. Rinsho Shinkeigaku. 2016;56(1):27-31. Japanese. doi: 10.5692/clinicalneurol.cn-000780.
https://doi.org/10.5692/clinicalneurol.cn-000780
Zhou W, Lai J, Huang T, Xu Y, Hu S. Cryptococcal meningitis mimicking cerebral infarction: A case report. Clin Interv Aging. 2018;13:1999-2002. doi: 10.2147/CIA.S181774
https://doi.org/10.2147/CIA.S181774
Hodges K, Hamouda D, Sun R, Li X. A challenging case of rapidly progressive dementia: cryptococcal meningitis patient with co-existing positive anti- NMDA receptor antibody in CSF (4248). Neurology. 2020;94(15 Suppl).
Thompson L, Porte L, Díaz V, et al. Cryptococcus bacillisporus (VGIII) Meningoencephalitis Acquired in Santa Cruz, Bolivia. J Fungi (Basel). 2021;7(1):55. doi: 10.3390/jof7010055.