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- W2205155592 abstract "A 46-year-old man, HIV seropositive, was admitted with two weeks history of fever, headache, vomiting and meningism. Physical examination revealed fever (38,5°C), stiffneck and other signs of meningeal involvement. During the hospitalization, he presented a gradually sensorial compromise. Neuroimaging showed leptomeningeal enhancing with non-enhancing parenchymal periventricular lesions compatible with cryptococcomas ( Figure 1 ) and numerous clustered foci hyperintense in the basal ganglia, internal capsule and thalamus, bilaterally, representing dilated Virchow-Robin perivascular spaces ( Figure 2, arrows). Cerebrospinal fluid (CSF) examination showed hyperproteinorrachia (2,28 g/L) glucose concentration 22 mg/dL and pleocytosis of 40 cels/uL (95% of monocytes). Direct examination with India ink, Grocott ( Figure 3 ) and PAS ( Figure 4 ) stains showed the presence of capsulated yeasts with a double refractive wall compatible with Cryptococcus . CSF cultures showed colonies of Cryptococcus neoformans, identified as C. neoformans var neoformans . Cryptococcal antigen in CSF was 1/100 and antigenemia was 1/100. Cryptococcosis is a life-threatening opportunistic infection caused by the yeast fungus Cryptococcus neoformans . Is a commonly opportunistic disease in immunocompromised patients, especially those with HIV/AIDS. Central nervous system is the most frequent extrapulmonary form of the disease and the most often lethal form of the disseminated disease. Neuroimagins can show the leptomeningeal enhancement and small lesions can be seen in the cerebral periventricular white matter named as gelatinous pseudocysts. Also, large size lesions named as cryptococcomas can be observed in the brain tissue [1]. The most frequent clinical form of neurocryptococcosis is the meningoencephalitis; the basal meninges are especially affected [2]. The most common imaging findings include leptomeningeal enhancement and Virchow-Robin spaces dilatation that correspond to small pseudocysts collections of gelatinous material present in cryptococcal organisms [3]. Less frequent manifestation include a large size lesions named as cryptococcomas, generally observed in the deep of the brain tissue [4]. Received: January 3, 2015; Accepted: November 11, 2015; Published: December 29, 2015 Corresponding Author: Marcelo Corti, Infectious Diseases F. J. Muniz Hospital, Puan 381, 2° floor, C1406CQG, Buenos Aires, Argentina. E-mail: marcelocorti@fibertel.com.ar ." @default.
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- W2205155592 date "2015-12-29" @default.
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- W2205155592 title "Intracranial cryptococcosis in a patient with AIDS" @default.
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