Intramedullary cryptococcal granuloma of spinal cord: a case report

The budding yeast, Cryptococcus neoformans, is widely distributed throughout the world and causes opportunistic and non-contagious infections in man. Involvement of the central nervous system has been found in 70% of patients at the time of diagnosis, and meningitis or meningoencephalitis are the most common manifestations. Space-occupying cryptococcal granuloma, on the other hand, is infrequently encountered in the brain and extremely rare in the spinal cord. Seven cases of spinal torulomas (cryptococcal granuloma) have been reported in the available literature. Only one was intramedullary. Here an isolated case of intramedullary cryptococcal granuloma in the spinal cord in an immunocompetent patient is reported; diagnosis was by intraoperative frozen section. After two months of post-operative antifungal treatment, the clinical condition has received markedly improvement.