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CNS Cryptococcoma in an HIV-Positive Patient

University of Buenos Aires, and Francisco J Muñiz Hospital, Buenos Aires, Argentina

Julio Fumagalli, MD

University of Buenos Aires, Buenos Aires, Argentina

Ruben Shinzato, MD

Francisco J Muñiz Hospital, Buenos Aires, Argentina

Héctor Gulotta, MD

Francisco J Muñiz Hospital, Buenos Aires, Argentina

Marcela Toller, MD

Francisco J Muñiz Hospital, Buenos Aires, Argentina

Javier Bava, MD, PhD

National University of La Plata, Buenos Aires, Argentina

This is the first case of brain cryptococcoma in an AIDS patient reported in Argentina. The patient was a 28-year-old white heterosexual man with AIDS who presented with altered mental status, seizures, visual hallucinations, headache, and fever without significant focal neurological deficit. He had a lumbar puncture, and was treated for cryptococcal meningitis. Subsequent brain CT scanning and MRI disclosed a mass lesion in the occipital lobe. Histopathological examination of biopsy was compatible with cryptococcoma, and tissue culture revealed Cryptococcus neoformans. Resolution of the mass and edema resulted after treatment with intravenous amphotericin B for six weeks, which was followed with maintenance oral fluconazole.

Intracranial mass is an uncommon complication in AIDS patients with cryptococcosis, and cryptococcoma should be considered as differential diagnosis of brain mass lesion in these patients. The etiologic diagnosis is necessary because central nervous system (CNS) toxoplasmosis, lymphoma, and tuberculoma can produce similar clinical syndromes and MRI or CT findings to cryptococcoma. Also, these pathologies may coexist with meningeal cryptococcosis.

Key Words: cryptococcoma • HIV infection • central nervous system • neurologic complications

Journal of the International Association of Physicians in AIDS Care (JIAPAC), Vol. 1, No. 4, 131-133 (2002)
DOI: 10.1177/154510970200100404


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