Pseudocystic form of neurocryptococcosis in pregnancy: case report

We report a case of neurocryptococcosis which is unique in the literature because the patient had a pseudocystic form of the disease during pregnancy and without any evidence of AIDS. The clinical picture was that of intracranial hypertension and the epidemiological background was highly suggestive of cysticercosis. CT showed multiple round hypodense lesions in the basal ganglia and cerebellum, without contrast enhancement. Since a scolex was not visible, the diagnosis of neurocysticercosis was considered probable. CSF examination was not performed in view of its high risk. The patient had progressive downhill course. Autopsy disclosed multiple gelatinous pseudocysts in the cerebral and cerebellar gray matter, containing abundant Cryptococcus neoformans. Meningeal involvement was minimal. The child was delivered by caesarean section and was free of infection, but died later of hyaline membrane disease. The neuroimaging appearances of this rare instance of the pseudocystic form of neurocryptococcosis mimicked closely neurocysticercosis and only postmortem examination allowed correct diagnosis. The pseudocystic form has so far only been reported in AIDS.

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Main Authors: NUCCI,ANAMARLI, MACIEL JR,JAYME ANTUNES, QUEIROZ,LUCIANO DE SOUZA, MONTENEGRO,MARIA AUGUSTA, CARVALHO,RITA BARBOSA DE
Format: Digital revista
Language:English
Published: Academia Brasileira de Neurologia - ABNEURO 1999
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X1999000400023
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spelling oai:scielo:S0004-282X19990004000232000-12-06Pseudocystic form of neurocryptococcosis in pregnancy: case reportNUCCI,ANAMARLIMACIEL JR,JAYME ANTUNESQUEIROZ,LUCIANO DE SOUZAMONTENEGRO,MARIA AUGUSTACARVALHO,RITA BARBOSA DE neurocryptococcosis neurocysticercosis pregnancy pseudocysts We report a case of neurocryptococcosis which is unique in the literature because the patient had a pseudocystic form of the disease during pregnancy and without any evidence of AIDS. The clinical picture was that of intracranial hypertension and the epidemiological background was highly suggestive of cysticercosis. CT showed multiple round hypodense lesions in the basal ganglia and cerebellum, without contrast enhancement. Since a scolex was not visible, the diagnosis of neurocysticercosis was considered probable. CSF examination was not performed in view of its high risk. The patient had progressive downhill course. Autopsy disclosed multiple gelatinous pseudocysts in the cerebral and cerebellar gray matter, containing abundant Cryptococcus neoformans. Meningeal involvement was minimal. The child was delivered by caesarean section and was free of infection, but died later of hyaline membrane disease. The neuroimaging appearances of this rare instance of the pseudocystic form of neurocryptococcosis mimicked closely neurocysticercosis and only postmortem examination allowed correct diagnosis. The pseudocystic form has so far only been reported in AIDS.info:eu-repo/semantics/openAccessAcademia Brasileira de Neurologia - ABNEUROArquivos de Neuro-Psiquiatria v.57 n.3A 19991999-09-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X1999000400023en10.1590/S0004-282X1999000400023
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libraryname SciELO
language English
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author NUCCI,ANAMARLI
MACIEL JR,JAYME ANTUNES
QUEIROZ,LUCIANO DE SOUZA
MONTENEGRO,MARIA AUGUSTA
CARVALHO,RITA BARBOSA DE
spellingShingle NUCCI,ANAMARLI
MACIEL JR,JAYME ANTUNES
QUEIROZ,LUCIANO DE SOUZA
MONTENEGRO,MARIA AUGUSTA
CARVALHO,RITA BARBOSA DE
Pseudocystic form of neurocryptococcosis in pregnancy: case report
author_facet NUCCI,ANAMARLI
MACIEL JR,JAYME ANTUNES
QUEIROZ,LUCIANO DE SOUZA
MONTENEGRO,MARIA AUGUSTA
CARVALHO,RITA BARBOSA DE
author_sort NUCCI,ANAMARLI
title Pseudocystic form of neurocryptococcosis in pregnancy: case report
title_short Pseudocystic form of neurocryptococcosis in pregnancy: case report
title_full Pseudocystic form of neurocryptococcosis in pregnancy: case report
title_fullStr Pseudocystic form of neurocryptococcosis in pregnancy: case report
title_full_unstemmed Pseudocystic form of neurocryptococcosis in pregnancy: case report
title_sort pseudocystic form of neurocryptococcosis in pregnancy: case report
description We report a case of neurocryptococcosis which is unique in the literature because the patient had a pseudocystic form of the disease during pregnancy and without any evidence of AIDS. The clinical picture was that of intracranial hypertension and the epidemiological background was highly suggestive of cysticercosis. CT showed multiple round hypodense lesions in the basal ganglia and cerebellum, without contrast enhancement. Since a scolex was not visible, the diagnosis of neurocysticercosis was considered probable. CSF examination was not performed in view of its high risk. The patient had progressive downhill course. Autopsy disclosed multiple gelatinous pseudocysts in the cerebral and cerebellar gray matter, containing abundant Cryptococcus neoformans. Meningeal involvement was minimal. The child was delivered by caesarean section and was free of infection, but died later of hyaline membrane disease. The neuroimaging appearances of this rare instance of the pseudocystic form of neurocryptococcosis mimicked closely neurocysticercosis and only postmortem examination allowed correct diagnosis. The pseudocystic form has so far only been reported in AIDS.
publisher Academia Brasileira de Neurologia - ABNEURO
publishDate 1999
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X1999000400023
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