title: Fluorescence in a cryptococcoma following administration of 5-aminolevulinic acid hydrochloride (Gliolan).
abstract: A 54-year-old man presented with two episodes of dysarthria and left facial droop. Both episodes resolved by the time of examination. MRI of the brain revealed a right frontotemporal, heterogeneously enhancing mass with surrounding vasogenic oedema, suggestive of a high-grade primary brain neoplasm. The patient was administered preoperative 5-aminolevulinic acid hydrochloride (Gliolan), and fluorescence-guided resection of the lesion was undertaken.Cryptococcus gattiiinfection was diagnosed from the specimen and the patient was given appropriate antifungal treatment. This is the first reported case of Gliolan-mediated fluorescence in a fungal abscess and highlights one of the potential pitfalls in fluorescence-guided surgery.
authors.affiliation: Department of Neurosurgery, John Hunter Hospital, New Lambton, New South Wales, Australia waldo.g.solis@outlook.com.
authors.forename: Waldo Gerard
authors.initials: WG
authors.lastname: Solis
authors.affiliation: Department of Neurosurgery, John Hunter Hospital, New Lambton, New South Wales, Australia.
authors.forename: Mitchell
authors.initials: M
authors.lastname: Hansen
mesh_terms: D000622:Aminolevulinic Acid / Q000008:administration & dosage*; D000935:Antifungal Agents / Q000627:therapeutic use; D001921:Brain / Q000000981:diagnostic imaging*; D003453:Cryptococcosis / Q000175:diagnosis* / Q000188:drug therapy; D056285:Cryptococcus gattii / Q000302:isolation & purification*; D003937:Diagnosis, Differential; D004401:Dysarthria / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017319:Photosensitizing Agents / Q000008:administration & dosage*; D025321:Surgery, Computer-Assisted
chemical_list: D000935:Antifungal Agents; D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid
keywords: Drug therapy related to surgery; Infectious diseases; Neurosurgery