TY - JOUR
T1 - Puerperal brain cryptococcoma in an HIV-negative woman successfully treated with fluconazole
T2 - A case report
AU - Hagan, José Edward
AU - Dias, Jesângeli Sousa
AU - Villasboas-Bisneto, José Caetano
AU - Falcão, Melissa Barreto
AU - Ko, Albert Icksang
AU - Ribeiro, Guilherme Sousa
PY - 2014/5
Y1 - 2014/5
N2 - Cryptococcus spp. cerebral abscesses are uncommon in immunocompetent subjects. The recommended induction treatment is the administration of amphotericin B plus flucytosine combined with resection for lesions ≥3cm. In this paper, we describe an HIV-negative woman diagnosed with a large cryptococcoma in the immediate postpartum period. The lesion was not resected, and due to amphotericin B intolerance, she received an extended course of fluconazole monotherapy. There was no disease recurrence during the 4 years of follow-up. The abrupt onset of her symptoms following delivery suggests that she developed a postpartum immune reconstitution syndrome. This case also demonstrates that in specific situations fluconazole monotherapy can be attempted in immunocompetent patients with cryptococcoma.
AB - Cryptococcus spp. cerebral abscesses are uncommon in immunocompetent subjects. The recommended induction treatment is the administration of amphotericin B plus flucytosine combined with resection for lesions ≥3cm. In this paper, we describe an HIV-negative woman diagnosed with a large cryptococcoma in the immediate postpartum period. The lesion was not resected, and due to amphotericin B intolerance, she received an extended course of fluconazole monotherapy. There was no disease recurrence during the 4 years of follow-up. The abrupt onset of her symptoms following delivery suggests that she developed a postpartum immune reconstitution syndrome. This case also demonstrates that in specific situations fluconazole monotherapy can be attempted in immunocompetent patients with cryptococcoma.
KW - Cryptococcus
KW - Immune reconstitution inflammatory syndrome
KW - Treatment
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U2 - 10.1590/0037-8682-0215-2013
DO - 10.1590/0037-8682-0215-2013
M3 - Article
C2 - 24861306
AN - SCOPUS:84901287716
VL - 47
SP - 254
EP - 256
JO - Revista da Sociedade Brasileira de Medicina Tropical
JF - Revista da Sociedade Brasileira de Medicina Tropical
SN - 0037-8682
IS - 2
ER -