Open AccessBrain cryptococcoma in immunocompetent patient. A case report
Author(s) -
Luiz Gabriel Gonçalves Cherain,
Carollayne Mendonça Rocha,
Marcos Antônio de Oliveira,
Denis Batista Pereira,
Michelli Bárbara Pinto,
Nícollas Nunes Rabelo
Publication year - 2020
Publication title -
jornal brasileiro de neurocirurgia
Language(s) - English
Resource type - Journals
eISSN - 2446-6786
pISSN - 0103-5118
DOI - 10.22290/jbnc.v31i4.1905
Subject(s) - cryptococcus neoformans , cryptococcosis , medicine , cryptococcus gattii , vomiting , differential diagnosis , cryptococcus , lesion , nausea , central nervous system , disease , pathology , intensive care medicine , surgery , biology , genetics , microbiology and biotechnology
Cryptococcosis commonly associated with immunosuppressed individuals is an infection caused by Cryptococcus neoformans/var. gattii. This infection has high mortality worldwide. C. neoformans inhabits the lung, later spreading to the Central Nervous System (CNS) which is the most significant site in the clinical manifestation of the disease. However, the prevalence in the CNS is low in immunocompetent individuals. Case presentation: A 42-year-old woman presented only headache, nausea, vomiting and simple partial epileptic seizure. Neuroimaging showed an expansive hypointense frontal lesion and a neurosurgical treatment was proposed, confirmed by histopathological analysis. Discussion: The exposure to C. neoformans among human populations is almost ubiquitous. The immunological status of the patient, the parasitic load and the virulence of the infectious strain are fundamental for the progression of the pathology. The balance of these factors is decisive for the prognosis. Currently, treatment is limited and consists of long term antifungal therapy. Conclusion: In this case, the necessity of differential diagnosis like brain tumors (e.g.: lymphoma and glioblastoma multiforme), resulting in poor prognosis and late treatment is seen. A neurosurgical approach should be instituted as soon as possible when pharmacological treatment is ineffective.