# Pneumocystis Pneumonia and Disseminated Cryptococcosis Dual Infection: A Case Report

## TL;DR

This case report details a 56-year-old HIV patient with dual infections of Pneumocystis pneumonia and disseminated cryptococcosis, highlighting the challenges in diagnosis and treatment.

## Contribution

The novelty lies in the rare co-occurrence of PCP and cryptococcosis in an HIV patient and the subsequent neurological complications.

## Key findings

- Chest CT and bronchoalveolar lavage confirmed Pneumocystis pneumonia in the HIV patient.
- Cryptococcus neoformans was identified, leading to a diagnosis of disseminated cryptococcosis.
- Post-treatment, the patient developed hemorrhagic cerebral lesions requiring neurosurgical intervention.

## Abstract

Human immunodeficiency virus (HIV) is a virus that targets and destroys a cluster of differentiation 4 (CD4) cells. When left untreated, HIV can lead to acquired immunodeficiency syndrome (AIDS), which the presence of AIDS-defining diseases can characterize. Here, the authors report the diagnostic and therapeutic approach to a case of a 56-year-old male living with HIV who presented to the emergency department with dyspnea and fever. Chest CT revealed ground-glass opacities, consistent with Pneumocystis pneumonia (PCP). Bronchoalveolar lavage culture confirmed PCP, and Cryptococcus neoformans was also identified. Lumbar puncture and MRI endorsed the diagnosis of disseminated cryptococcosis. The patient underwent targeted treatment for both opportunistic infections. However, after completing the therapeutic scheme, his neurologic condition deteriorated, and cerebral CT revealed hemorrhagic lesions, necessitating transfer to a neurosurgery unit.