Infect Chemother.  2012 Feb;44(1):17-21. 10.3947/ic.2012.44.1.17.

Multiple Opportunistic Infections and Primary Central Nervous System Lymphoma in a Patient with Idiopathic CD4+ T-lymphocytopenia

• Song JS
• Choe PG
• Song KH
• Park KU
• Park WB
• Park SW
• Kim NJ
• Oh MD
• Kim HB

• KMID: 1782393
• DOI: http://doi.org/10.3947/ic.2012.44.1.17

Abstract

We describe a case of idiopathic CD4+ T-lymphocytopenia (ICL) in a 59-year-old patient who presented with various opportunistic infections. The patient was diagnosed with disseminated Mycobacterium avium infection, cytomegalovirus colitis and retinitis, and esophageal candidiasis. He was successfully treated with anti-mycobacterial drugs, ganciclovir, and fluconazole, respectively. However, the patient was diagnosed with primary central nervous system lymphoma, and then died of a Trichosporon beigelii sepsis during the 2nd cycle of systemic chemotherapy.

Keyword

Idiopathic CD4+ T-lymphocytopenia; Opportunistic infection; CNS lymphoma

MeSH Terms

Candidiasis
Central Nervous System
Colitis
Cytomegalovirus Infections
Fluconazole
Ganciclovir
Humans
Lymphoma
Lymphopenia
Middle Aged
Mycobacterium avium
Opportunistic Infections
Retinitis
Sepsis
T-Lymphocytopenia, Idiopathic CD4-Positive
Trichosporon
Fluconazole
Ganciclovir
Lymphopenia

Figure

• 

  Figure 1 Patient's clinical course. AMB, amphotericin B; AMK, amikacin; Ara-C, cytarabine; CMV, cytomegalovirus; CTM, clarithromycin; EMB, ethambutol; FCZ, fluconazole; GCV, ganciclovir; INH, isoniazid; LFX; levofloxacin; MTX, methotrexate; MAC, mycobacterium avium complex; PCNSL, primary central nervous system lymphoma; PZA, pyrazinamide; RFB, rifabutin; RIF, rifampin; SMX/TMP, sulfamethoxazole/Trimethoprim.

• 

  Figure 2 Magnetic resonance image (T2-weighted) of the brain shows ring-enhanced lesions in the left basal ganglia and temporal lobe.

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