title: Histopathological aspects of neurocryptococcosis in HIV-infected patients: autopsy report of 45 patients.
abstract: The authors describe the histopathological necropsy findings of 45 human immunodeficiency virus (HIV)-infected patients with neurocryptococcosis. Systemic cryptococcosis with involvement of multiple organs such as spleen, liver, and lungs was present in all patients. Predominant diffuse meningoencephalitis predominantly in the basal ganglia, thalamus, and mid-brain, with minimal inflammatory infiltrate was seen in 30 AIDS patients (70%). We frequently observed in those patients the presence of multiple gelatinous pseudocysts with abundant Cryptococcus neoformans in the Virchow-Robin spaces and adjacent brain caused by the dissemination of the meningeal infection along the perivascular spaces. Isolated meningeal and cerebral involvement with minimal inflammatory infiltrate with numerous fungal organisms, and occasionally with granulomatous reaction and necrosis, was seen in 15 patients (30%). In addition to involvement of multiple organs by C. neoformans, HIV-infected patients with clinical manifestations of neurocryptococcosis frequently present a widespread involvement of the brain.
authors.affiliation: Infectious Diseases Unit and Pathology Section, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil.
authors.forename: Clóvis
authors.initials: C
authors.lastname: Klock
authors.forename: Marselle
authors.initials: M
authors.lastname: Cerski
authors.forename: Luciano Z
authors.initials: LZ
authors.lastname: Goldani
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology / Q000401:mortality / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001344:Autopsy; D001921:Brain / Q000382:microbiology / Q000473:pathology*; D001938:Brazil / Q000453:epidemiology; D002648:Child; D003455:Cryptococcus neoformans / Q000302:isolation & purification* / Q000378:metabolism; D003560:Cysts / Q000382:microbiology / Q000473:pathology; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D016919:Meningitis, Cryptococcal / Q000401:mortality / Q000473:pathology*; D008875:Middle Aged; D009093:Mucus / Q000378:metabolism / Q000382:microbiology; D013116:Spinal Cord / Q000382:microbiology / Q000473:pathology*; D055815:Young Adult