Successful medical treatment of multiple cryptococcomas: report of a case and literature review

J Med Assoc Thai. 1999 Oct;82(10):991-9.

Abstract

We report a 35-year-old man diagnosed as having CNS cryptococcosis with multiple cryptococcomas, presenting with headache, papilloedema and impaired mental function in a previously healthy man. Cerebrospinal fluid (CSF) examination revealed lymphocytic pleocytosis with low glucose level. Gram's stain, acid fast bacilli stain and Indian ink examination were all negative. CSF cryptococcal antigen was positive, however, several fungal cultures were negative. Early cranial CT scan showed focal cerebritis over the right temporal lobe while subsequent imaging studies showed multiple contrast-enhancing masses with severe surrounding brain oedema over bilateral frontoparietal areas. Brain biopsy showed cryptococcal granulomatous lesions. Treatment was successful with antifungal agents and steroids without surgical removal.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Amphotericin B / therapeutic use
  • Antifungal Agents / therapeutic use
  • Antigens, Fungal / blood
  • Biopsy
  • Brain / diagnostic imaging
  • Brain / pathology
  • Cryptococcus / immunology
  • HIV Seronegativity
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Meningitis, Cryptococcal / cerebrospinal fluid
  • Meningitis, Cryptococcal / diagnosis*
  • Meningitis, Cryptococcal / drug therapy
  • Tomography, X-Ray Computed

Substances

  • Antifungal Agents
  • Antigens, Fungal
  • Amphotericin B