Disseminated cryptococcosis associated with administration of eculizumab.

Publication Title

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists

Authors

Megan Clancy, Infectious Disease Division, Providence Alaska Medical Center, Anchorage, AK.Follow
Ryan McGhan, Pulmonary/Critical Care Division, Providence Alaska Medical Center, Anchorage, AK.Follow
Jeremy Gitomer, Nephrology Division, Providence Alaska Medical Center, Anchorage, AK.Follow
Ana Marie Inocencio, Microbiology Department, Providence Alaska Medical Center, Anchorage, AK.Follow
Christina Aldrich, Pharmacy Department, Providence Alaska Medical Center, Anchorage, AK.Follow
Roberto Iaderosa, Pharmacy Department, Providence Alaska Medical Center, Anchorage, AK.Follow
Ryan Stevens, Pharmacy Department, Providence Alaska Medical Center, Anchorage, AK.Follow

Document Type

Article

Publication Date

7-15-2018

Keywords

Cryptococcus neoformans; disseminated cryptococcosis; eculizumab

Abstract

PURPOSE: A case report of fatal disseminated cryptococcosis in a patient treated with eculizumab is presented along with a review of literature suggesting a possible etiologic mechanism.

SUMMARY: A 23-year-old man with a history of minimal change nephrotic syndrome was hospitalized for acute kidney injury and abdominal pain and swelling. He was found to have disseminated pneumococcal disease, including peritonitis, bacteremia, and pulmonic endocarditis. The patient developed evidence of microangiopathic hemolytic anemia, leading to a diagnosis of atypical hemolytic uremic syndrome, and was started on eculizumab. The patient initially improved but developed septic shock 18 days after the first dose of eculizumab. All subsequent blood, respiratory, and intraabdominal cultures grew

CONCLUSION: A 23-year-old man developed fatal disseminated cryptococcosis after treatment with eculizumab.

Clinical Institute

Kidney & Diabetes

Specialty/Research Institute

Nephrology

Specialty/Research Institute

Infectious Diseases

Specialty/Research Institute

Pharmacy