[A case of cryptococcal meningoencephalitis, which damaged the medial part of the temporal lobe and caused gradually progressing memory disturbance].
A 71-year-old female was admitted to the National Cardiovascular Center, complaining of memory disturbance that had been gradually worsening for about two years. Neurologically, except for the memory disturbance, higher brain functions were almost normal and there were no signs of meningeal irritation. A cerebrospinal fluid examination showed lymphocytic dominant pleocytosis, elevated protein levels and decreased glucose levels. Furthermore, Cryptococcus neoformans was detected in the cerebrospinal fluid. A brain CT demonstrated a low density area at the medial part of the left temporal lobe. This lesion appeared as a low intensity area in the T1 weighted image, and as a high intensity area in the T2 weighted image in MRI, and was enhanced by the administration of Gadolinium-DTPA. After administration of fluconazole, improvements were observed in cerebrospinal fluid findings and the enhancement effect of Gadolinium-DTPA in MRI also became unclear on the lesion inside the left temporal lobe. No worsening of the memory disturbance was observed. It was presumed that the gradually progressive memory disturbance had been triggered by the cryptococcus-caused meningoencephalitis, in particular the damage at the medial part of the temporal lobe.
Nakamura
K
K
Tanaka
Y
Y
Oita
J
J
Yamaguchi
T
T
D000368:Aged; D003453:Cryptococcosis; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D008569:Memory Disorders / Q000209:etiology*; D008590:Meningoencephalitis / Q000150:complications / Q000382:microbiology* / Q000473:pathology; D013702:Temporal Lobe / Q000473:pathology*
D015725:Fluconazole