1887

Abstract

Introduction:

is an emerging global pathogen. Recent reports suggest that cryptococcosis is more common in immunocompetent as well as HIV-infected patients than earlier estimated. We report the first case of cerebellar cryptococcoma from India due to in an immunocompetent individual.

Case Presentation:

A 73-year-old immunocompetent male, presented with a 3 month history of severe headache, neck stiffness, walking difficulty, bilateral papilloedema and slight cerebellar signs including gait imbalance and giddiness. Magnetic resonance imaging (MRI) revealed a well-defined enhancing lesion in the cerebellum, suggestive of abscess and mild hydrocephalus. Blood parameters and liver function tests were within normal limits. The patient underwent paramedian suboccipital craniotomy, and the aspirated purulent material grew . Histologically, the lesion was a cryptococcoma. The isolate was further identified as VGI, serotype C, mating type alpha, and produced extracellular phospholipase enzyme. It was sensitive to amphotericin B, 5-flucytosine and azoles. The patient was treated with intravenous amphotericin B (0.7 mg kg day) for 15 days along with a maintenance dose of oral fluconazole (400 mg day) for 6 months. The patient's symptoms recovered while on treatment but he was lost to follow up.

Conclusion:

is an emerging pathogen in India that affects otherwise healthy, immunocompetent individuals and requires rapid identification and treatment in order to prevent severe neurological sequelae.

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2015-06-01
2019-11-22
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