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Published on: March 18, 2020

Central nervous system cryptococcoma in immunocompetent patients: a short review illustrated by a new case

Qiang Li1, Chao You, Qian Liu

  • 1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.

Acta Neurochirurgica
|May 1, 2009
PubMed

Insights

Cryptococcal granuloma in the central nervous system (CNS) is rare in immunocompetent individuals. This study reviews cases, highlighting diagnosis and treatment of CNS cryptococcoma in non-HIV patients.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Mycology

Background:

  • Central nervous system (CNS) cryptococcal infections are common in immunocompromised patients, particularly those with HIV.
  • Cryptococcal granuloma (cryptococcoma) in the CNS of immunocompetent individuals is an infrequent clinical presentation.

Observation:

  • This report details a new case of CNS cryptococcoma in an immunocompetent patient.
  • A literature review identified 17 cases of CNS cryptococcoma in immunocompetent patients, including the presented case.
  • Symptoms included symptomatic presentation despite normal immunocompetency, with some patients having comorbidities like diabetes.

Findings:

  • Magnetic Resonance (MR) imaging may suggest cryptococcoma with ring-enhancing lesions, potentially with cystic changes.
  • Definitive diagnosis of CNS cryptococcoma requires histopathological examination of lesion specimens.
  • Treatment typically involves surgical intervention and antifungal therapy.

Implications:

  • Early recognition of CNS cryptococcoma in immunocompetent patients is crucial for timely diagnosis and management.
  • The location of the cryptococcal granuloma significantly influences patient outcomes.
  • Further research into optimal diagnostic and therapeutic strategies for CNS cryptococcoma in immunocompetent hosts is warranted.
Abstract

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