A Case of HIV Positive Systemic Cryptococcal Infection: Postmortem Diagnose

Cryptococcus neoformans is a highly mortal opportunistic yeast causing pneumonia and meningoencephalitis in cases with HIV infection. In rare cases, it causes systemic infections, spreading to organs like the spleen, liver, and kidneys. In this paper we present the post-mortem evaluation results of a systemic cryptococcal infection in a HIV-positive case found dead at home. A 30-year-old, 167 cm tall, 57 kg Chinese man found dead at home was sent to the Morgue Department for autopsy. In the anogenital region, multiple papular lesions,which were found 1 cm in diameter, off-white, having hard consistency, and raising from surface, were found. In autopsy, edema was found in the brain and cerebellum and cerebellar tonsils were prominent. The brain weighed 1561 g. Right lung was found 943 g and left lung 800 g in weight. Yeast growth was observed in the aerobic cultures of CSF, lung and spleent issue. The yeast form was defined as C. neoformans with API 32 C and Maldi-T of method. In addition, Serratia marcescens grew in blood and lung tissue culture. Plenty of gram-negative bacilli were seen in the Gram stain of tissue smear. In the post mortem histopathological examination of the tissues, histiocytic-pneumonia caused by cryptococcus and bacterial bronchopneumonia findings were seen in lungs and the parenchyma of the brain, and other organs were reported to be widely in vaded with cryptococcus. HIV-RNA was found positive in high quantitation in the blood sample of the case. HIVpositive immunocompromised people often die due to opportunistic infections. Our case died due to pneumonia infection caused by C. neoformans and secondary infection with S. marcescens and meningo encephalitis caused by systemic cryptococcus infection. Therefore, AIDS and related opportunistic infections should be strongly considered in cases where there is death of a foreign person at home with unknown clinical data and stories.