caa a22 4500 44535626X CHVBK 20180317142901.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s10072-011-0496-5 doi (NATIONALLICENCE)springer-10.1007/s10072-011-0496-5 Difficulty diagnosing chronic cryptococcal meningitis in idiopathic CD4+ lymphocytopenia [Elektronische Daten] [Giuseppe Sancesario, Giampiero Palmieri, Gemma Viola, Carla Fontana, Alessandra Perfetti, Lucia Anemona, Roberto Floris, Simone Marziali, Giorgio Bernardi, Luigi Spagnoli] A 64-year-old man with idiopathic CD4+ lymphocytopenia developed cognitive impairment and gait ataxia with isolated obstructive hydrocephalus, which was fatal. Cerebrospinal fluid showed mild pleocytosis, but the etiology was not revealed by extensive analysis. At autopsy, inflammatory cells, CD8+ lymphocytes and abundant macrophages but not CD4+ lymphocytes were infiltrating the meninges at the base of the brain. Electron microscopy demonstrated that inflammation was caused by Cryptococcus neoformans, which was localized exclusively within macrophages, where it grew with budding. Our study suggests that, in idiopathic CD4+ lymphocytopenia, macrophages can efficiently phagocytize but inefficiently digest C. neoformans, thus representing a vehicle of chronic intracellular infection. Springer-Verlag, 2011 Cryptococcosis nationallicence Cryptococcus neoformans nationallicence Idiopathic CD4 lymphocytopenia nationallicence Macrophages nationallicence Electron microscopy nationallicence Sancesario Giuseppe Dipartimento di Neuroscienze, Università di Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy aut Palmieri Giampiero Department of Biopathology, University of Rome Tor Vergata, Rome, Italy aut Viola Gemma Department of Internal Medicine, University of Rome Tor Vergata, Rome, Italy aut Fontana Carla Dipartimento di Neuroscienze, Università di Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy aut Perfetti Alessandra Department of Biopathology, University of Rome Tor Vergata, Rome, Italy aut Anemona Lucia Department of Biopathology, University of Rome Tor Vergata, Rome, Italy aut Floris Roberto Department of Biopathology, University of Rome Tor Vergata, Rome, Italy aut Marziali Simone Department of Biopathology, University of Rome Tor Vergata, Rome, Italy aut Bernardi Giorgio Dipartimento di Neuroscienze, Università di Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy aut Spagnoli Luigi Department of Biopathology, University of Rome Tor Vergata, Rome, Italy aut Neurological Sciences Springer Milan 32/3(2011-06-01), 519-524 1590-1874 32:3<519 2011 32 10072 https://doi.org/10.1007/s10072-011-0496-5 text/html Onlinezugriff via DOI 1 brief-communication jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10072-011-0496-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sancesario Giuseppe Dipartimento di Neuroscienze, Università di Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy aut NATIONALLICENCE 700 1- Palmieri Giampiero Department of Biopathology, University of Rome Tor Vergata, Rome, Italy aut NATIONALLICENCE 700 1- Viola Gemma Department of Internal Medicine, University of Rome Tor Vergata, Rome, Italy aut NATIONALLICENCE 700 1- Fontana Carla Dipartimento di Neuroscienze, Università di Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy aut NATIONALLICENCE 700 1- Perfetti Alessandra Department of Biopathology, University of Rome Tor Vergata, Rome, Italy aut NATIONALLICENCE 700 1- Anemona Lucia Department of Biopathology, University of Rome Tor Vergata, Rome, Italy aut NATIONALLICENCE 700 1- Floris Roberto Department of Biopathology, University of Rome Tor Vergata, Rome, Italy aut NATIONALLICENCE 700 1- Marziali Simone Department of Biopathology, University of Rome Tor Vergata, Rome, Italy aut NATIONALLICENCE 700 1- Bernardi Giorgio Dipartimento di Neuroscienze, Università di Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy aut NATIONALLICENCE 700 1- Spagnoli Luigi Department of Biopathology, University of Rome Tor Vergata, Rome, Italy aut NATIONALLICENCE 773 0- Neurological Sciences Springer Milan 32/3(2011-06-01), 519-524 1590-1874 32:3<519 2011 32 10072 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer