{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T12:54:58Z","timestamp":1766408098926,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,9,27]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>Infection by human T-lymphotropic virus 1 (HTLV-1) is often seen as the cause of chronic infection or lymphoproliferative disorders, but many clinicians do not recognise its association with severe immunosuppression. We report the case of a woman in her 70s from the Caribbean who sought care at the emergency department for weakness, fatigue and weight loss. Further work-up showed atypical lymphocytosis with floral lymphocytes and smudge cells in the peripheral blood smear and hypercalcaemia. Chest CT demonstrated a moderate right pleural effusion. Results of HIV testing were negative, and screening and confirmatory tests for HTLV-1 were positive. Empiric antibiotic therapy was administered, and the patient was discharged home. Five days later, she was readmitted with shortness of breath and severe abdominal pain. A disseminated infection with <jats:italic>Cryptococcus neoformans<\/jats:italic> was diagnosed. Despite aggressive intravenous antifungal therapy, the patient died on day 7 of hospitalisation.<\/jats:p>","DOI":"10.1136\/bcr-2020-235794","type":"journal-article","created":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T12:50:05Z","timestamp":1611838205000},"page":"e235794","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Disseminated cryptococcosis in a patient with newly diagnosed HTLV-1 infection"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6534-2691","authenticated-orcid":false,"given":"Gabriel","family":"Motoa","sequence":"first","affiliation":[{"name":"Division Of Allery and Pulmonary Medicine, Mayo Clinic, Jacksonville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harry Ross","family":"Powers","sequence":"additional","affiliation":[{"name":"Divsion Of Infectious Diseases, Mayo Clinic, Jacksonville, Florida, 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