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Persistence of cryptococcomas on neuroimaging
1Clinical Mycology Section, Laboratory of Clinical Investigation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA. Duane.Hospenthal@amedd.army mil.
Abstract:
Three previously normal patients with cryptococcal meningitis had intracranial lesions on computed tomography and magnetic resonance imaging that persisted for >5 years after successful cure with antifungal drugs. Persistence of lesions on neuroimaging should not be misinterpreted as evidence of active cryptococcosis.
Insights
Persistent brain lesions after cryptococcal meningitis treatment are common. These imaging findings do not indicate active infection, preventing misdiagnosis in patients cured with antifungal drugs.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Cryptococcal meningitis is a serious fungal infection affecting the central nervous system.
- Neuroimaging is crucial for diagnosing and monitoring meningitis, but interpretation of findings can be challenging.
Observation:
- Intracranial lesions were observed in three patients with cryptococcal meningitis.
- These lesions persisted on computed tomography and magnetic resonance imaging for over five years.
Findings:
- Successful antifungal treatment cured the patients' cryptococcal meningitis.
- Despite cure, the intracranial lesions remained visible on neuroimaging studies.
Implications:
- Persistent neuroimaging lesions should not be mistaken for active cryptococcosis.
- This distinction is vital for accurate patient management and avoiding unnecessary treatments.