Correct!
4. 1 and 3
Cryptococcosis is a potentially fatal fungal disease (1). It is caused by one of two species; Cryptococcus neoformans or Cryptococcus gattii. Cryptococcosis is believed to be acquired by inhalation and is frequently seen in immunocompromised hosts and is a defining opportunistic infection for AIDS. Other conditions which pose an increased risk for cryptococcosis include lymphomas, sarcoidosis, liver cirrhosis and patients on long-term corticosteroid therapy. It has only rarely been reported in immunocompetent hosts or as a nonpathogenic colonizing organism. Pulmonary cryptococcosis is frequently associated with meningitis/encephalitis especially in immunocompromised hosts. The patient’s cerebrospinal fluid cryptococcal antigen was negative. However, the CSF had a slightly elevated cell count of 7 cells/HPF all lymphocytes. The protein was also slightly elevated at 61 mg/dL and his glucose was slightly low at 53 mg/dL. An infectious disease consultant interpreted these findings as consistent with cryptococcal meningitis.
Which of the following should be ordered for the work up of this possibly immunocompromised patient?