Literature DB >> 31863401

Cryptococcal meningoencephalitis presenting as cerebral venous thrombosis.

Jon Equiza1, Gorka Fernandez-Eulate2, Jon Rodriguez-Antigüedad2, David Campo-Caballero2, Amaia Muñoz-Lopetegi2, Miguel-Angel Goenaga Sanchez3, Jose Angel Larrea4, Ana de Arce Borda2.   

Abstract

Cerebral venous thrombosis (CVT) is characterized by its variety of neurological manifestations and difficulty in diagnosis. In subacute cases, the main symptoms are secondary to increased intracranial pressure. This condition is associated with an extensive range of medical disorders, but only 2% are caused by a CNS infection in recent series. We report a 45-year-old patient, with no previous medical history, who developed a syndrome of increased intracranial pressure as the presentation of a cryptococcal meningoencephalitis (CM) complicated with a CVT. The patient was first diagnosed of a CVT, and later on, the VIH infection and the CM diagnosis were made. Despite being treated with anticoagulation, liposomal amphotericin B, and a therapeutic lumbar puncture, the patient continued to deteriorate and suffered a respiratory arrest secondary to the increased intracranial pressure, with subsequent brain death. Cryptococcus is an infrequent cause of CNS infection in developed countries, despite being the most frequent cause of meningits in adults in several countries with high rates of HIV infection. CVT is a very rare complication of CM which can contribute to worsen the increased intracranial pressure and in consequence, its prognosis and outcome. A high level of suspicion is needed for diagnosing CM as the underlying cause of CVT and the subsequent increased intracranial pressure should be managed exhaustively.

Entities:  

Keywords:  Cerebral venous thrombosis; Cryptococcus neoformans; Fungal infections; HIV; Meningitis

Mesh:

Year:  2019        PMID: 31863401     DOI: 10.1007/s13365-019-00813-3

Source DB:  PubMed          Journal:  J Neurovirol        ISSN: 1355-0284            Impact factor:   2.643


  1 in total

1.  A Rare Case of Cryptococcus gattii Meningitis in Advanced HIV Disease, Sagittal Thrombosis, and Immune Reconstitution Syndrome, Resolved With Isavuconazonium.

Authors:  Jerome Okudo; Valerie F Civelli; Vishal K Narang; Royce H Johnson; Nadir Khan; Brittany Andruszko; Arash Heidari
Journal:  J Investig Med High Impact Case Rep       Date:  2020 Jan-Dec
  1 in total

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