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Original ArticleOpen Access
Successful Medical Treatment of Multiple Cryptococcomas : Report of a Case and Literature Review
Arayawichanont A 
,
Prayoonwiwat N ,
Churojana A ,
Sangruchi T ,
Poungvarin N
,
Prayoonwiwat N ,
Churojana A ,
Sangruchi T ,
Poungvarin N We report a 35 year old man diagnosed as having CNS cryptococcosis with multiple cryptococcomas,
presenting with headache, papilloedema and impaired mental function in a previously
healthy man. Cerebrospinal fluid (CSF) examination revealed lymphocytic pleocytosis with low
glucose level. Gram's stain, acid fast bacilli stain and Indian ink examination were all negative.
CSF cryptococcal antigen was positive, however, several fungal cultures were negative. Early
cranial CT scan showed focal cerebritis over the right temporal lobe while subsequent imaging
studies showed multiple contrast-enhancing masses with severe surrounding brain oedema over
bilateral frontoparietal areas. Brain biopsy showed cryptococcal granulomatous lesions. Treatment
was successful with antifungal agents and steroids without surgical removal.
Key word : Cerebral Cryptococcosis, Cryptococcoma, CNS Cryptococcosis
presenting with headache, papilloedema and impaired mental function in a previously
healthy man. Cerebrospinal fluid (CSF) examination revealed lymphocytic pleocytosis with low
glucose level. Gram's stain, acid fast bacilli stain and Indian ink examination were all negative.
CSF cryptococcal antigen was positive, however, several fungal cultures were negative. Early
cranial CT scan showed focal cerebritis over the right temporal lobe while subsequent imaging
studies showed multiple contrast-enhancing masses with severe surrounding brain oedema over
bilateral frontoparietal areas. Brain biopsy showed cryptococcal granulomatous lesions. Treatment
was successful with antifungal agents and steroids without surgical removal.
Key word : Cerebral Cryptococcosis, Cryptococcoma, CNS Cryptococcosis
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