Meningoencephalitis due to Cryptococcus neoformans: a case report

Authors

  • Eduardo Sixto Galindo Portuondo
  • Ana María León Blasco
  • Rafael Pila Pérez
  • Osyalky Ramírez Cancio
  • Ana Emilia Morell Artola

Keywords:

Meningitis, Meningoencephalitis, Cryptococcus neoformans

Abstract

INTRODUCTION: The meningitis/meningo–encephalitis caused by Cryptococcus neoformans is the more frequent clinical presentation of infection by fungus in the central nervous system, with a progressive increment of prevalence in the last years and actually is necessary to think always about this possibility and especially in patients with immunodeficiency.

CASE REPORT:
Female, 23 years old, who presented a serious neurological disease a few days after a provoked abort. By the clinic symptoms, physical examination and the results of tests realized, she was diagnosed as a patient with meningitis/meningo–encephalitis by Cryptococcus neoformans.

CONCLUSIONS:
Studies such as cultivation of cerebrospinal fluid in Sabouraud and Indian ink staining of CSF showed the Cryptococcus Neoformans and corroborated the diagnosis. The treatment was completed with liposomal amphotericin B and fluconazole; the evolution was favorable and the patient was asymptomatic after antifungal therapy.

Downloads

Download data is not yet available.

References

1. Diamond RD. Cryptococcus neoformans. In Mandell GL, Douglas RG, Bennett JE, eds. Principles and practice infections disease. 5th ed, New York: John Wiley and Sons; 2000:1460–68.

2. Band J, Talavera F, King J, Mylonakis E, Cunha B, editors. Cryptococcosis. Emedicine.com. New York. [Internet]. [Actualizado 30 Oct 2009; citado 20 Sep 2010]. [aprox. 20 p.] Disponible en: http://emedicine.medscope.com/article/215354–overview

3. Chen J, Varma A, Diaz MR, Litvintseva AP, Wollenberg KK, Kwon–Chung KJ. Cryptococcus neoformans Strains and Infection in Apparently Immunocompetent Patients, China. Emerging Infectious Diseases Emerg Infect Dis. 2008;14(5):755–62.

4. Iqbal N, DeBess EE, Wohrle R, Sun B, Nett RJ, Ahlquist AM, et al. Cryptococcus gattii Public Health Working Group. J Clin Microbiol. 2010; 48(2):539–44.

5. Meyer W, Aanensen DM, Boekhout T, Cogliati M, Diaz MR, Esposto MC, et al. Consensus multi–locus sequence typing scheme for Cryptococcus neoformans and Cryptococcus gattii. Med Mycol. 2009; 47(6):561–70.

6. Hernández Benedicto R, Pila Pérez R, Holguín Prieto V, Curvelo Vidal L, Torres Vargas E. Meningoencefalitis por cryptococcus neoformans: Presentación de tres casos. Enf Emerg (Esp). 2011;13(2):86–91.

7. Kauffmarv CA. Cryptococcosis. In: Arewd WP, Anwitage JO, Clemmons DR, Drazen JM, Griggs RC, Larruso N, eds. Cecil Medicine (CD – ROM) 23rd ed, Saundens Elsevier; Philadelphia; 2008.

8. Bretaudeau K, Eloy O, Richer A, Bruneel F, Scott–Algara D, Lortholary O, Pico F. Cryptococcal meningo–encephalitis in an apparently immunocompetent patient. Rev Neurol (Paris). 2006;162(2):233–7.

9. Aragão RE, Muccioli C, Barrreira IM, Ribeiro DC, Timóteo CN. Bilateral amaurosis due to cryptococcus meningoencephalitis: case report. Arq Bras Oftalmol. 2008;71(1):101–3.

10. Davis JA, Horn DL, Marr KA, Fishman JA. Central nervous system involvement in cryptococcal infection in individuals after solid organ transplantation or with AIDS. Transpl Infect Dis. 2009;11(5):432–7.

11. Casa de Vall A. Cryptococcosis. In: Fauci As, Kaspen DL, Longo DL, Braunwald E, Hausen ST, Jamenson JL, Loscalzo J, eds. Harrison´s Principles of Internal Medicine (CD – ROM) 17th ed, New York: Mc Graw – Hill; 2008.

12. Chayakulkeeree M, Perfect J. Cryptococcosis. Infect Dis Clin North Am 2006;20(3):507–44.

13. Perfect J R. Cryptococcocus Neoformans. In Mandell GL, Bennett JE, Dolin R, Mandell, Douglas and Bennett´s, eds. Principles and practice of infectious disease, 6th ed, Orlando: Churchill Livigstone; 2006:2997–3009.

14. Lin TY, Yeh KM, Lin JC, Wang NC, Peng MY, Chang FY. Cryptococcal disease in patients with or without human immunodeficiency virus: clinical presentation and monitoring of serum cryptococcal antigen titers. J Microbiol Immunol Infect. 2009;42(3):220–6.

15. Lee YC, Wang JT, Sun HY, Chen YC. Comparisons of clinical features and mortality of cryptococcal meningitis between patients with and without human immunodeficiency virus infection. J Microbiol Immunol Infect. 2011;44(5):338–45.

16. Eric Searls D, Sico JJ, Bulent Omay S, Bannykh S, Kuohung V, Baehring J. Unusual presentations of nervous system infection by Cryptococcus neoformans. Clin Neurol Neurosurg. 2009;111(7):638–42.

17. Sivasangeetha K, Harish BN, Sujatha S, Parija SC, Dutta TK. Cryptococcal meningoencephalitis diagnosed by blood culture. Indian J Med Microbiol. 2007;25(3):282–4.

18. Pfaller MA. Global trends in the antifungal susceptibility of cryptococcocus neoformans (1990–2004). J Clin Microbiol, 2006;43(5):2163–7.

Published

2014-07-01

How to Cite

1.
Galindo Portuondo ES, León Blasco AM, Pila Pérez R, Ramírez Cancio O, Morell Artola AE. Meningoencephalitis due to Cryptococcus neoformans: a case report. Rev Cubana Neurol Neurocir [Internet]. 2014 Jul. 1 [cited 2025 Jul. 3];4(2):148-52. Available from: https://revneuro.sld.cu/index.php/neu/article/view/141

Issue

Section

Case presentation