title: [Cryptococcal meningitis in a patient with a ventriculoperitoneal shunt and monitoring for pulmonary sarcoidosis].
abstract: The fungus Cryptococcus neoformans can cause common opportunistic infection in acquired immune deficiency syndrome (AIDS) patients. But other conditions can be associated with sarcoidosis. Meningoencephalitis is the most common manifestation of this disease. One of the most important neurological complications is the development of intracranial hypertension (ICH), which may result in high morbidity and mortality. We report the case of a patient harboring a ventriculoperitoneal shunt, and having contracted a cryptococcal meningitis as a risk factor for pulmonary sarcoidosis. Brain MRI showed arachnoiditis, with a mass in contact with the right frontal horn. Indian ink staining of the cerebrospinal fluid (CSF) showed positivity that was confirmed by the identification of Cryptococcus neoformans after culture. The evolution was favorable under medical treatment with removal of material. The relationship between sarcoidosis and cryptococcosis, described in the literature is not coincidental but is a rare complication of sarcoidosis of potential severity (40% of mortality). Sarcoidosis is a common systemic disease that may increase host susceptibility to CNS cryptococcal infection without any other signs or symptoms of host immunosuppression. The diagnosis of cryptococcosis should be evoked as a differential diagnosis of neuro-sarcoidosis.
authors: Service de neurochirurgie, hôpital militaire d'instruction Mohamed-V, Hay Riyad, Rabat, Maroc. baallalnch@gmail.com
authors: H
authors: H
authors: Baallal
authors: A C
authors: AC
authors: El Asri
authors: B
authors: B
authors: Eljebbouri
authors: A
authors: A
authors: Akhaddar
authors: M
authors: M
authors: Gazzaz
authors: B
authors: B
authors: El Mostarchid
authors: M
authors: M
authors: Boucetta
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001100:Arachnoiditis / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D002244:Carbon; D002555:Cerebrospinal Fluid / Q000382:microbiology; D004396:Coloring Agents; D003221:Confusion / Q000209:etiology; D003455:Cryptococcus neoformans / Q000302:isolation & purification; D004198:Disease Susceptibility; D004359:Drug Therapy, Combination; D005437:Flucytosine / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016919:Meningitis, Cryptococcal / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011595:Psychomotor Agitation / Q000209:etiology; D017565:Sarcoidosis, Pulmonary / Q000150:complications*; D013194:Staining and Labeling; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*
chemical_list: D000935:Antifungal Agents; D004396:Coloring Agents; C028433:chinese ink; C068538:liposomal amphotericin B; D002244:Carbon; D000666:Amphotericin B; D005437:Flucytosine