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Volume 359:207-209 July 10, 2008 Number 2
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Case 11-2008: Mental-Status Changes after Liver Transplantation

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 by Fishman, J. A.
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To the Editor: We would like to make two points about the case of disseminated cryptococcosis in a liver-transplant recipient, discussed in the Case Records by Fishman et al. (April 10 issue).1 The first point concerns delayed diagnosis of this infection in patients with negative tests for human immunodeficiency virus infection. We believe that in the case presented, a correct diagnosis could have been suspected from day 13 onward on the basis of the patient's recurrent headaches. In immunocompromised patients, severe and persistent headache should prompt the performance of lumbar puncture.2

The second point is the low awareness among physicians . . . [Full Text of this Article]




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