Disseminated cryptococcosis with varicella-zoster virus coinfection of idiopathic CD4+T lymphocytopenia: a case report and literature review

Background Idiopathic CD4 + T lymphocytopenia (ICL) is a rare immunodeficiency syndrome, unaccompanied by various opportunistic infections. Cryptococcus and varicella-zoster viruse are the most common opportunistic infections. Method We described a case of disseminated cryptococcosis with varicella-zoster virus coinfection in a patient with ICL and reviewed all published reports. A total of 26 cases with cryptococcal meningitis in ICL were enrolled. Discussion ICL remains poorly understood to clinicians. Patients with cryptococcal meningitis in ICL mostly suffered with headache and fever in a subacute or chronic period, while some patients might have atypical manifestations which makes a difficulty for early diagnosis. Some characteristics of cerebrospinal fluid can help to predict the prognosis of the disease. Cryptococcosis with varicella-zoster virus coinfection is rare but serious. Conclusion We recommed CD4 + T cells should be assessed in patients with unusual or recurrent infections. As the underlying pathophysiology is poorly understood, there is no standard therapy for ICL. Increased awareness of the disease and early prevention for CD4 reduction are needed.

Automated summary

Idiopathic CD4 + T lymphocytopenia (ICL) is a rare immunodeficiency syndrome. This article describes a case of disseminated cryptococcosis with varicella-zoster virus co-infection in a patient with ICL and reviews published reports. The pathophysiology and treatment of ICL remain poorly understood, highlighting the importance of increased awareness and early prevention of the disease.