[Neurological form of cryptococcosis. Apropos of 2 atypical cases in non HIV-infected patients].
Cryptococcal infection is the most common fungal infection of the central nervous system. More than 50% of the cases of cryptococcal infection are superimposed on an immunosuppressive or other general debilitating condition. Cerebral cryptococcosis usually presents as meningitis or meningoencephalitis, although cerebral granuloma has also been reported. Hydrocephalus is the most common neurosurgical complication of cerebral cryptococcosis. The majority of patients require only medical treatment with antifungal drugs. However, when complications ensue, surgical intervention is mandatory. We suggest that chronic meningitis be ruled out in all patients prior to the placement of shunts. In the two cases reported here treatment of cryptococcal meningitis was a combination of amphotericin B and flucytosine for six weeks. Fluconazole is a new alternative and at least as effective as amphotericin B.
Donnet
A
A
Service de Neurochirurgie, CHU Timone, Marseille.
Graziani
N
N
Harlé
J R
JR
Durand
J M
JM
Touta
A
A
Grisoli
F
F
D000293:Adolescent; D000328:Adult; D000361:Agammaglobulinemia / Q000150:complications; D000666:Amphotericin B / Q000627:therapeutic use; D001922:Brain Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D001927:Brain Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D003453:Cryptococcosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D005437:Flucytosine / Q000627:therapeutic use; D018023:HIV Seronegativity; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D009894:Opportunistic Infections / Q000150:complications* / Q000188:drug therapy
D000666:Amphotericin B; D005437:Flucytosine
Formes neurologiques de la cryptococcose. A propos de 2 cas atypiques chez des patients non infectés par le VIH.