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[An autopsy case of cryptococcal meningoencephalitis: correlation of MRI and pathologic findings]

Hitoshi Ueda1, Yasuhisa Toribe, Yuko Kuwae

  • 1Divisions of Pediatric Neurology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka. h_ueda@omichikai.or.jp

No to Hattatsu = Brain and Development
|November 25, 2003
PubMed

Insights

This study compares MRI and pathology in a rare case of cryptococcal meningoencephalitis. Characteristic "soap bubble lesions" in the basal ganglia seen on MRI aid in diagnosing this fungal brain infection.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Medical Imaging

Background:

  • Cryptococcal meningoencephalitis is a serious fungal infection of the brain and meninges.
  • Early diagnosis is crucial for effective treatment and improved patient outcomes.

Observation:

  • An 11-year-old female presented with neurological symptoms including confusion and vomiting.
  • Cerebrospinal fluid analysis revealed fungal cells, pleocytosis, low glucose, and high protein.
  • Magnetic Resonance Imaging (MRI) demonstrated punctate lesions in the basal ganglia and diffuse meningeal enhancement.

Findings:

  • Pathological examination confirmed T2-weighted MRI lesions in the basal ganglia represented cryptococcal invasion of Virchow-Robin spaces, forming characteristic "soap bubble lesions".
  • MRI findings correlated with post-mortem pathological findings, highlighting the diagnostic utility of imaging.

Implications:

  • MRI findings, particularly "soap bubble lesions" in the basal ganglia and meningeal enhancement, are valuable diagnostic indicators for cryptococcal meningoencephalitis.
  • This case underscores the importance of integrating neuroimaging with clinical and laboratory data for accurate diagnosis.

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