• Mai Katsura, Ayako Okuhama, Yoshiki Koizumi, Naokatsu Ando, Yasuaki Yanagawa, Daisuke Mizushima, Takahiro Aoki, Kunihisa Tsukada, Katsuji Teruya, Yoshimi Kikuchi, Shinichi Oka, and Koji Watanabe.
• AIDS Clinical Center of the National Center for Global Health and Medicine, Japan.
• Intern. Med. 2022 Jan 15; 61 (2): 257-261.

AbstractCytopenia is a common complication in patients with human immunodeficiency virus (HIV) infection. Identifying the cause is demanding because of the wide range of possible diagnoses. We herein report an HIV-infected patient with disseminated cryptococcosis involving multiple organs including the blood, brain, lungs, and bone marrow, who developed progressive pancytopenia after initiation of anti-fungal treatment with liposomal amphotericin-B (L-AMB) and flucytosine (5FC). The pancytopenia persisted despite early 5FC discontinuation. A bone marrow biopsy revealed cryptococcal infiltration and the blood examination findings recovered quickly after resuming L-AMB. Thus, this HIV-infected patient's pathological findings and clinical course suggested that the primary cause of the pancytopenia was bone marrow cryptococcosis.

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