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Seizure in isolated brain cryptococcoma: Case report and review of the literature
Laura Brunasso1, Roberta Costanzo1, Antonio Cascio2
1Department of Biomedicine, Neurosciences and Advanced Diagnostic, Section of Neurosurgery, University of Palermo, Palermo, Italy.
Background:
Central nervous system (CNS) cryptococcosis is an invasive fungal infection predominantly seen among immunosuppressed patients causing meningitis or meningoencephalitis. Rarely, cryptococcosis can affect immunologically competent hosts with the formation of localized CNS granulomatous reaction, known as cryptococcoma. Common symptoms of CNS cryptococcoma are headaches, consciousness or mental changes, focal deficits, and cranial nerve dysfunction. Rarely, seizures are the only presenting symptom.
Case Description:
We report the case of an immunocompetent patient with a solitary CNS cryptococcoma presenting with a long history of non-responsive generalized seizure who has been successfully operated.
Conclusion:
CNS cryptococcoma is a rare entity, and in immunocompetent patients, its diagnosis can be challenging. The pathophysiology of lesion-related seizure is discussed along with a review of the pertinent literature.
Insights
Central nervous system (CNS) cryptococcoma, a rare fungal infection, can present solely as seizures in immunocompetent individuals. Surgical removal offers a successful treatment option for this challenging diagnosis.
Area of Science:
- Neurology
- Infectious Diseases
- Mycology
Background:
- Central nervous system (CNS) cryptococcosis is typically an opportunistic infection in immunosuppressed individuals, often manifesting as meningitis.
- Localized CNS granulomatous reactions, termed cryptococcoma, can occur rarely in immunocompetent hosts.
Observation:
- A case of an immunocompetent patient with a solitary CNS cryptococcoma is presented.
- The patient exhibited a prolonged history of generalized seizures unresponsive to conventional treatment.
Findings:
- Successful surgical resection of the CNS cryptococcoma was achieved.
- This case highlights seizures as a rare but presenting symptom of CNS cryptococcoma in immunocompetent individuals.
Implications:
- Diagnosis of CNS cryptococcoma in immunocompetent patients can be difficult.
- Understanding the pathophysiology of lesion-induced seizures is crucial for managing such rare neurological presentations.
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