Artículos de revistas
Pseudocystic Form Of Neurocryptococcosis In Pregnancy: Case Report
Registro en:
Arquivos De Neuro-psiquiatria. , v. 57, n. 3 A, p. 678 - 682, 1999.
0004282X
2-s2.0-0033181966
Autor
Nucci A.
Maciel Jr. J.A.
De Souza Queiroz L.
Montenegro M.A.
De Carvalho R.B.
Institución
Resumen
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. 57 3 A 678 682 Pereira, C., Fishman, O., Colombo, A.L., Moron, A.F., Pignatari, A., Neurocriptococose durante a gravidez: Revisão da literatura e relato de dois casos (1993) Rev Inst Med Trop São Paulo, 35, pp. 367-371 Stein, S.C., Corrado, M.L., Friedlander, M., Farmer, P., Chronic mycotic meningitis with spinal involvement (arachnoiditis): A report of five cases (1982) Ann Neurol, 11, pp. 519-524 Chen, C.P., Wang, K.G., Cryptococcal meningitis in pregnancy (1996) Am J Perinatol, 13, pp. 35-36 Chotmongkol, V., Sookprasert, A., Itraconazole in cryptococcal meningitis in pregnancy: A case report (1992) J Med Assoc Thai, 75, pp. 606-608 Del Brutto, O.H., Wadia, N.H., Dumas, M., Cruz, M., Tsang, V., Schantz, P.M., Proposal of diagnostic criteria for human cysticercosis and neurocysticercosis (1996) J Neurol Sci, 142, pp. 1-6 Garcia, C.A., Weisberg, L.A., Lacorte, W., Cryptococcal intracerebral mass lesions: CT-pathologic considerations (1985) Neurology, 35, pp. 731-734 Miszkiel, K.A., Mah, C., Miller, R.F., The spectrum of MRI findings in CNS cryptococcosis in AIDS (1996) Clin Radiol, 51, pp. 842-850 Edelman, M., Birkenhauer, M.C., Steinberg, J.J., Dickson, D.W., Casadevall, A., Lee, S.C., Microglial nodule encephalitis: Limited CNS infection despite disseminated systemic cryptococcosis (1996) Clin Neuropathol, 15, pp. 30-33 Molnar-Nadasdy, G., Haesly, I., Reed, J., Altshuler, G., Placental cryptococcosis in a mother with systemic lupus erythmatosus (1994) Arch Pathol Lab Med, 118, pp. 757-759 Johnson, R.T., Infections during pregnancy (1994) Neurological Complications of Pregnancy, pp. 153-162. , Devinsky O, Feldmann E, Hainline (eds). New York : Raven Press