Cerebral torulosis: clinical features and correlation with computed tomography.

Area of Science:

• Medical Mycology
• Infectious Diseases
• Neurology

Background:

• Cryptococcus neoformans, also known as Torula histolytica, is an infrequent cause of central nervous system (CNS) infections.
• Reviewing recent cases provides insight into the clinical and radiological presentation of this opportunistic fungal pathogen.

Purpose of the Study:

• To analyze the clinical and radiological features of Cryptococcus neoformans CNS infections.
• To correlate imaging findings with clinical severity in a series of patients.

Main Methods:

• Retrospective review of 15 cases of Cryptococcus neoformans CNS infection over a 6-year period in Queensland.
• Analysis of computed tomography (CT) findings, including lesion characteristics and comparison with clinical presentation.

Main Results:

• Computed tomography (CT) abnormalities were present in 73.5% of cases, commonly showing mass lesions and hydrocephalus.
• A notable discrepancy was observed between the severity of clinical symptoms and CT findings, with some CTs showing minimal changes.
• Specific radiological observations included absent enhancement in granulomas (2 cases) and calcification during treatment (1 case).

Conclusions:

• Cryptococcus neoformans CNS infections present with diverse CT findings, ranging from significant mass lesions to subtle granulomas.
• The clinical presentation can be disproportionately severe compared to imaging results, necessitating careful clinical-radiological correlation.
• Radiological features like lack of enhancement and calcification may occur in the course of cryptococcal CNS disease.