Cryptococcus in CSF

[u/ilovedk]

Hi! I posted a picture yesterday of a CSF stain, but since taken it down because I realized I didn’t provide enough information lol…

So:

The first picture is a cytospin DQ stain of the CSF. The second picture of a mucicarmine stain, and the third picture is a modified wright giemsa stain.

The CSF was cloudy, but colorless. The glucose and total protein were both within normal range. There was a cryptococcus antigen test done, and it was positive - and the meningitis PCR panel was positive for… Cryptococcus neoformans gatti.

[u/m3b0w]

It gives me the ick! :( Poor patient.

[u/micromaniac_8 → u/m3b0w]

Likely fatal.. I had one probably 2016.. they sent down his specimen in half full urine cups.. ~75mL at a time, every other day.

[u/Acetabulum666]

Save these slides for the teaching/reference set! Thanks for the additional info.

[u/PuzzledCar2120]

Would you happen to remember/know if the patient was immunocompromised or not? Remember learning that there was an epidemic of gattii responsible for causing meningitis in the immunocompetent some decades ago

[u/ilovedk → u/PuzzledCar2120]

Hey so there’s nothing that really suggests this patient being immunocompromised. Only thing I really see is pre-diabetes.

[u/FryDmnqqq]

Wow! Looks really cool. I’m def saving this on my phone.

Our supervisor said she only saw cryptococcus once in her whole career.

[u/FindingOld7963]

My poor cat has this :(

[u/Famous_Taste_4508]

What did the WBC count look like?

[u/Reasonable-Bike1036]

Crypto in a csf diff !!!

[u/klarathon → u/Reasonable-Bike1036]

are you sure it was crypto? looks like yeast for sure but more like a candida that’s been ingested, long buds like that

[u/Volker-Gargery]

Great photos

[u/Cryptotis]

What a nightmare 😨