Hidden in plain sight: urinary Cryptococcus neoformans missed by routine diagnostics in a patient with acute leukemia

Zoe F. Weiss; James E. DiCarlo; David W. Basta; Stephanie Kent; Alexis Liakos; Lindsey Baden; Manfred Brigl; Sanjat Kanjilal; Connie Cañete-Gibas; Nathan P. Wiederhold; Sankha S. Basu

doi:10.1186/s12941-022-00540-4

Hidden in plain sight: urinary Cryptococcus neoformans missed by routine diagnostics in a patient with acute leukemia

Zoe F. Weiss, James E. DiCarlo, David W. Basta, Stephanie Kent, Alexis Liakos, Lindsey Baden, Manfred Brigl, Sanjat Kanjilal, Connie Cañete-Gibas, Nathan P. Wiederhold, Sankha S. Basu

Department of Pathology

Research output: Contribution to journal › Article › peer-review

Abstract

Cryptococcuria is a rare manifestation of localized cryptococcal disease. We present a case of Cryptococcus neoformans urinary tract infection in an immunocompromised host missed by routine laboratory workup. The patient had negative blood cultures, a negative serum cryptococcal antigen (CrAg), and “non-Candida yeast” growing in urine culture that was initially dismissed as non-pathogenic. The diagnosis was ultimately made by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) from a repeat urine culture after transfer to a tertiary care center. Cryptococcus should be considered in the differential of refractory urinary tract infections growing non-Candida yeast.

Original language	English (US)
Article number	49
Journal	Annals of Clinical Microbiology and Antimicrobials
Volume	21
Issue number	1
DOIs	https://doi.org/10.1186/s12941-022-00540-4
State	Published - Dec 2022

Keywords

Cryptoccouria
Cryptococcal antigen
Cryptococcal infection
Cryptococcus neoformans
India-ink
MALDI-TOF MS

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases

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10.1186/s12941-022-00540-4

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Weiss, Z. F., DiCarlo, J. E., Basta, D. W., Kent, S., Liakos, A., Baden, L., Brigl, M., Kanjilal, S., Cañete-Gibas, C., Wiederhold, N. P., & Basu, S. S. (2022). Hidden in plain sight: urinary Cryptococcus neoformans missed by routine diagnostics in a patient with acute leukemia. Annals of Clinical Microbiology and Antimicrobials, 21(1), Article 49. https://doi.org/10.1186/s12941-022-00540-4

Weiss, ZF, DiCarlo, JE, Basta, DW, Kent, S, Liakos, A, Baden, L, Brigl, M, Kanjilal, S, Cañete-Gibas, C, Wiederhold, NP & Basu, SS 2022, 'Hidden in plain sight: urinary Cryptococcus neoformans missed by routine diagnostics in a patient with acute leukemia', Annals of Clinical Microbiology and Antimicrobials, vol. 21, no. 1, 49. https://doi.org/10.1186/s12941-022-00540-4

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abstract = "Cryptococcuria is a rare manifestation of localized cryptococcal disease. We present a case of Cryptococcus neoformans urinary tract infection in an immunocompromised host missed by routine laboratory workup. The patient had negative blood cultures, a negative serum cryptococcal antigen (CrAg), and “non-Candida yeast” growing in urine culture that was initially dismissed as non-pathogenic. The diagnosis was ultimately made by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) from a repeat urine culture after transfer to a tertiary care center. Cryptococcus should be considered in the differential of refractory urinary tract infections growing non-Candida yeast.",

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T2 - urinary Cryptococcus neoformans missed by routine diagnostics in a patient with acute leukemia

AU - Weiss, Zoe F.

AU - DiCarlo, James E.

AU - Basta, David W.

AU - Kent, Stephanie

AU - Liakos, Alexis

AU - Baden, Lindsey

AU - Brigl, Manfred

AU - Kanjilal, Sanjat

AU - Cañete-Gibas, Connie

AU - Wiederhold, Nathan P.

AU - Basu, Sankha S.

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N2 - Cryptococcuria is a rare manifestation of localized cryptococcal disease. We present a case of Cryptococcus neoformans urinary tract infection in an immunocompromised host missed by routine laboratory workup. The patient had negative blood cultures, a negative serum cryptococcal antigen (CrAg), and “non-Candida yeast” growing in urine culture that was initially dismissed as non-pathogenic. The diagnosis was ultimately made by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) from a repeat urine culture after transfer to a tertiary care center. Cryptococcus should be considered in the differential of refractory urinary tract infections growing non-Candida yeast.

AB - Cryptococcuria is a rare manifestation of localized cryptococcal disease. We present a case of Cryptococcus neoformans urinary tract infection in an immunocompromised host missed by routine laboratory workup. The patient had negative blood cultures, a negative serum cryptococcal antigen (CrAg), and “non-Candida yeast” growing in urine culture that was initially dismissed as non-pathogenic. The diagnosis was ultimately made by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) from a repeat urine culture after transfer to a tertiary care center. Cryptococcus should be considered in the differential of refractory urinary tract infections growing non-Candida yeast.

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KW - Cryptococcal antigen

KW - Cryptococcal infection

KW - Cryptococcus neoformans

KW - India-ink

KW - MALDI-TOF MS

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Hidden in plain sight: urinary Cryptococcus neoformans missed by routine diagnostics in a patient with acute leukemia

Abstract

Keywords

ASJC Scopus subject areas

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