A novel cause of emergent hyperammonemia: Cryptococcal fungemia and meningitis

William B Hannah; Gregory Nizialek; Katherine J Dempsey; Keith B Armitage; Shawn E McCandless; Laura L Konczal

doi:10.1016/j.ymgmr.2021.100825

A novel cause of emergent hyperammonemia: Cryptococcal fungemia and meningitis

Mol Genet Metab Rep. 2021 Nov 25:29:100825. doi: 10.1016/j.ymgmr.2021.100825. eCollection 2021 Dec.

Authors

William B Hannah^{1

2

3}, Gregory Nizialek^{4

5}, Katherine J Dempsey^{1

2}, Keith B Armitage⁴, Shawn E McCandless^{1

2

6}, Laura L Konczal^{1

2}

Affiliations

¹ Center for Human Genetics, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
² Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH, USA.
³ Department of Genetics, University of North Carolina, Chapel Hill, NC, USA.
⁴ Department of Internal Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
⁵ Department of Internal Medicine, MedStar Franklin Square Medical Center, Baltimore, MD, USA.
⁶ Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA.

Abstract

Among etiologies of hyperammonemic emergencies, infection must be considered in certain clinical contexts, particularly among immunocompromised individuals. Although Cryptococcus neoformans is known to be urease-producing, to our knowledge it has not previously been described as a cause of hyperammonemia in patients. We report an immunocompromised man with acute on chronic kidney disease with hyperammonemic crisis due to Cryptococcal meningitis and fungemia. It is important to be aware of C. neoformans as a possible cause of hyperammonemia.

Keywords: Cryptococcus neoformans; Hyperammonemia.

Publication types

Case Reports