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Intraventricular cryptococcal cysts masquerading as racemose neurocysticercosis

Marlon Mathews1, Laura Paré, Anton Hasso

  • 1Department of Neurosurgery, University of California, Irvine, Orange, CA 92868.

Surgical Neurology
|May 22, 2007
PubMed
Abstract

Insights

Central nervous system cryptococcal infections in immunocompetent individuals can mimic neurocysticercosis. Early diagnosis is crucial for appropriate treatment of these rare fungal CNS cysts.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Central nervous system (CNS) cryptococcal infections are rare in immunocompetent hosts.
  • Typically present as meningitis, hydrocephalus, or cryptococcomas.
  • This case highlights intraventricular cryptococcal cysts mimicking neurocysticercosis.

Observation:

  • A 23-year-old male presented with severe headache, dizziness, and lethargy.
  • Imaging revealed hydrocephalus and multiple intraventricular cysts.
  • Cerebrospinal fluid (CSF) analysis showed a meningitic pattern, and Cryptococcus neoformans antigen was detected.

Findings:

  • Despite negative neurocysticercosis serology, the presentation mimicked racemose neurocysticercosis.
  • The patient received antifungal therapy including amphotericin B, 5-FC, and fluconazole.
  • Neurological status returned to baseline with resolution of CSF Cryptococcus antigen.

Implications:

  • CNS cryptococcal infections can present atypically in immunocompetent individuals.
  • Distinguishing cryptococcal cysts from neurocysticercosis is critical due to different management strategies.
  • This case underscores the importance of considering fungal infections in CNS pathologies that mimic parasitic infections.

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