Question
A young HIV-positive male undergoes a thoracotomy for a lung mass. Frozen sections reveal Cryptococcus. What is the next step in the management of this patient?
| A. |
Start immediate therapy with antibiotics
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| B. |
Maintain respiratory isolation
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| C. |
Obtain cerebrospinal fluid
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| D. |
Measure CD4 count
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Show Answer
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Correct Answer � C
Explanation
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Obtain cerebrospinal fluid
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Cryptococcus has a great affinity for the meninges, and any patient who has a positive diagnosis of this organism in any part of the body (not just lung) requires a lumbar puncture.
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The latex agglutination test is relatively sensitive to identify this organism.
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Treatment is started immediately with amphotericin and 5-FU.
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Untreated cases have a very high mortality.