Cryptococcal peritonitis: Report of a case and review of the literature

We describe a patient diagnosed with AIDS and cirrhosis who had recently su ffered a self-limited and non-specific esophageal ulceration. After this, h e was hospitalized because of an oral bleeding with fatal evolution, and Cr yptococcus neoformans was isolated from ascitic fluid during a routine para centeses. We have reviewed the literature and, since 1963, only another 10 cases of cryptococcal peritonitis have been reported. A liver disease and n ot the AIDS (surprisingly, our case is the only report of cryptococcal peri tonitis in a subject having both diseases) was the most common underlying d isease (72.7%) and was associated with the worst prognosis (only one patien t survived). An oral or upper gastrointestinal bleeding was the most common associated circumstance although recent steroid or antibiotic therapy has been also reported. Finally, diagnosis was delayed in many patients. The re asons for these delays are discussed.