title: Atypical clinical and radiological presentation of cryptococcal choroid plexitis in an immunocompetent woman.
abstract: Central nervous system cryptococcal infections usually manifests as meningitis, meningoencephalitis, encephalitis or ventriculitis. Cryptococcal choroid plexus inflammation is a particularly rare entity most often presenting with signs and symptoms of intracranial hypertension, hydrocephalus or meningitis due to a delayed diagnosis. Herein we reported the case of a 63-year-old immunocompetent woman with a history of temporal lobe epilepsy and behavioral disorders. Magnetic resonance imaging (MRI) and fluorodeoxyglucose positron emission tomographic (FDG-PET) images revealed atypical cryptococcal choroid plexitis with surrounding bitemporal edema without features of meningitis, intraparenchymal cryptococcoma or hydrocephalus. The patient underwent serial MRI and FDG-PET images performed before and after antifungal therapy that caused a marked clinical improvement. Our case also suggests a potential role of FDG-PET in the monitoring antifungal therapeutic efficacy.
authors.affiliation: Department of Neurological Sciences, "Federico II" University of Naples, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Dubbioso
authors.forename: Sabina
authors.initials: S
authors.lastname: Pappatà
authors.forename: Mario
authors.initials: M
authors.lastname: Quarantelli
authors.forename: Felice
authors.initials: F
authors.lastname: D'Arco
authors.forename: Fiore
authors.initials: F
authors.lastname: Manganelli
authors.forename: Marcello
authors.initials: M
authors.lastname: Esposito
authors.forename: Lucio
authors.initials: L
authors.lastname: Santoro
mesh_terms: D002831:Choroid Plexus / Q000382:microbiology*; D003453:Cryptococcosis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D004487:Edema / Q000150:complications / Q000473:pathology; D005260:Female; D006801:Humans; D007121:Immunocompetence; D008875:Middle Aged; D059906:Neuroimaging
keywords: Behavioral disturbances; Cryptococcal choroid plexitis; FDG-PET; Granulomatous lesions; Immunocompetent host; Intraventricular cryptococcoma; MRI; Temporal lobe epilepsy