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Vertebral cryptococcosis simulating tuberculosis.

S K Gupta1, R Chhabra, B S Sharma

  • 1Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

British Journal of Neurosurgery
|February 6, 2004
PubMed
Summary
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Skeletal cryptococcosis, a rare fungal infection, can mimic tuberculosis and cause spinal cord compression. Early diagnosis through microscopic identification and prompt antifungal treatment are crucial for better patient outcomes.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Neurosurgery

Background:

  • Cryptococcus neoformans primarily causes pulmonary and cerebromeningeal infections.
  • Skeletal involvement, particularly in the thoracic vertebrae, is rare but can lead to severe complications like spinal cord compression.

Observation:

  • A young female initially treated for tuberculosis presented with rapidly progressive paraparesis.
  • Imaging revealed a destructive T2-3 vertebral lesion with a paraspinal abscess causing cord compression.

Findings:

  • Histopathological examination confirmed the lesion was cryptococcosis, not tuberculosis.
  • Despite surgical intervention and antifungal medication, the patient demised two weeks post-surgery.

Implications:

Related Experiment Videos

  • Vertebral cryptococcosis can present with radiological and surgical findings similar to tuberculosis, necessitating a high index of suspicion.
  • Definitive diagnosis relies on microscopic identification of the fungus.
  • Early surgical confirmation and initiation of antifungal therapy are vital to reduce mortality and morbidity in cases of skeletal cryptococcosis.