Puerperal brain cryptococcoma in an HIV-negative woman successfully treated with fluconazole: A case report

José Edward Hagan, Jesângeli Sousa Dias, José Caetano Villasboas-Bisneto, Melissa Barreto Falcão, Albert Icksang Ko, Guilherme Sousa Ribeiro

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)254-256
Number of pages3
JournalRevista da Sociedade Brasileira de Medicina Tropical
Volume47
Issue number2
DOIs
StatePublished - May 2014

Keywords

  • Cryptococcus
  • Immune reconstitution inflammatory syndrome
  • Treatment

ASJC Scopus subject areas

  • Parasitology
  • Microbiology (medical)
  • Infectious Diseases

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