Cryptococcal infection of the central nervous system

Two patients with cryptococcal infection of the central nervous system are described. The first presented with signs of an intracranial mass and was subsequently shown to have two lesions within the brain which were later identified as cryptococcal granulomata. Antifungal therapy did not eradicate the lesions; following their excision and continued therapy, the CSF became sterile however. The other patient had signs of a fulminant meningoencephalitis which initially were thought to represent the pathophysiological expression of an expanding brain tumor. These reports are used as a basis to review the various aspects of central nervous system cryptococcosis, particularly as they may relate to the neurosurgeon and the therapy of the disease.