Abdominal cyst formation following ventriculoperitoneal shunt in a case of hydrocephalus due to cryptococcal meningitis. Case report: completely cured by surgical removal of the cyst and treatment with a newly developed anti-fungal drug (Difulcan).
A 54-year-old woman was admitted to the hospital for evaluation of meningitis. Tuberculous meningitis was suspected initially because of general findings and a high adenosine deaminase activity (ADA) value in the cerebrospinal fluid. Administration of antituberculous drugs was not effective. Computed tomography scanning revealed progression of ventricular enlargement. A ventriculo-peritoneal shunt was placed upon diagnosis of hydrocephalus due to meningitis. The presence of a large abdominal cyst formation was demonstrated. Cryptococcus was detected in the cyst fluid, leading to a diagnosis of cryptococcal meningitis. Intravenous administration of fluconazole (400 mg/day) was begun. Excision of the cyst was performed when Cryptococcus was no longer detected in the cyst fluid. The patient recovered uneventfully.
Izumoto
S
S
Department of Neurosurgery, Center for Adult Diseases, Osaka, Japan.
Nakagawa
H
H
Fujita
T
T
Kubo
S
S
D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D003131:Combined Modality Therapy; D003560:Cysts / Q000382:microbiology / Q000628:therapy*; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use*; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000628:therapy*; D016919:Meningitis, Cryptococcal / Q000150:complications*; D008875:Middle Aged; D010532:Peritoneal Diseases / Q000382:microbiology / Q000628:therapy*
D015725:Fluconazole