COVID-19, HIV-Associated Cryptococcal Meningitis, Disseminated Tuberculosis and Acute Ischaemic Stroke: A Fatal Foursome

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dc.contributor.authorBongomin, Felix
dc.contributor.authorSereke, Senai Goitom
dc.contributor.authorOkot, Jerom
dc.contributor.authorKatsigazi, Ronald
dc.contributor.authorKiiza Kandole, Tadeo
dc.contributor.authorOriekot, Anthony
dc.contributor.authorOlum, Ronald
dc.contributor.authorAtukunda, Angella
dc.contributor.authorBaluku, Joseph Baruch
dc.contributor.authorNakwagala, Frederick
dc.date.accessioned2022-05-12T09:39:35Z
dc.date.available2022-05-12T09:39:35Z
dc.date.issued2021
dc.description.abstractSeveral viral, bacterial and fungal co-infections have been associated with increased morbidity and mortality among patients with COVID-19. We report a fatal case of severe COVID-19 pneumonia in a patient with a recent diagnosis of advanced HIV disease complicated by cryptococcal meningitis, disseminated tuberculosis and acute ischemic stroke. Case Presentation: A 37-year-old Ugandan woman was diagnosed with HIV infection 8 days prior to her referral to our center. She was antiretroviral naïve. Her chief complaints were worsening cough, difficulty in breathing, fever and altered mental status for 3 days with a background of a 1-month history of coughing with associated drenching night sweats and weight loss. The reverse transcriptase–polymerase chain reaction for SARS-CoV-2 of her nasopharyngeal swab sample was positive. Chest radiograph demonstrated military pattern involvement of both lungs. The serum and cerebrospinal fluid cryptococcal antigen tests were positive. Urine lipoarabinomannan and sputum GeneXpert were positive for Mycobacterium tuberculosis. Computed tomography of the brain showed a large acute ischemic infarct in the territory of the right middle cerebral artery. Regardless of the initiation of treatment, that is, fluconazole 1200 mg once daily, enoxaparin 60 mg, intravenous (IV) dexamethasone 6 mg once daily, oral fluconazole 1200 mg once daily, IV piperacillin/tazobactam 4.5 g three times daily and oxygen therapy, the patient passed on within 36 hours of admission. Conclusion: Co-infections worsen COVID-19 outcomes.en_US
dc.identifier.citationBongomin, F., Sereke, S. G., Okot, J., Katsigazi, R., Kandole, T. K., Oriekot, A., ... & Nakwagala, F. (2021). COVID-19, HIV-Associated Cryptococcal Meningitis, Disseminated Tuberculosis and Acute Ischaemic Stroke: A Fatal Foursome. Infection and Drug Resistance, 14, 4167. https://doi.org/10.2147/IDR.S335711en_US
dc.identifier.urihttps://doi.org/10.2147/IDR.S335711
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/3227
dc.language.isoenen_US
dc.publisherInfection and Drug Resistanceen_US
dc.subjectCOVID-19en_US
dc.subjectHIVen_US
dc.subjectCryptococcal meningitisen_US
dc.subjectStrokeen_US
dc.subjectTuberculosisen_US
dc.subjectCo-infectionen_US
dc.titleCOVID-19, HIV-Associated Cryptococcal Meningitis, Disseminated Tuberculosis and Acute Ischaemic Stroke: A Fatal Foursomeen_US
dc.typeArticleen_US
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