Successful medical treatment of multiple cryptococcomas: report of a case and literature review
Arayawichanont, A.; Prayoonwiwat, N.; Churojana, A.; Sangruchi, T.; Poungvarin, N.
Journal of the Medical Association of Thailand 82(10): 991-999
1999
ISSN/ISBN: 0125-2208 PMID: 10561961 Document Number: 1955
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.
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