Puerperal brain cryptococcoma in an HIV-negative woman successfully treated with fluconazole: a case report

Revista da Sociedade Brasileira de Medicina Tropical

Secretaria de Saúde do Estado da Bahia, Salvador, Brasil¹  Falcão, Melissa Barreto¹  Hagan, José Edward¹  Ko, Albert Icksang¹  Universidade Federal da Bahia, Salvador, Brasil¹  Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brasil¹  Yale School of Public Health, New Haven, USA¹  Ribeiro, Guilherme Sousa¹  Villasboas-Bisneto, José Caetano¹  Dias, Jesângeli Sousa¹ 

关键词: Cryptococcus;    Immune reconstitution inflammatory syndrome;    Treatment;   

DOI  :  10.1590/0037-8682-0215-2013

学科分类：农业科学（综合）

来源: Sociedade Brasileira de Medicina Tropical

【 摘 要 】

Cryptococcus spp. cerebral abscesses are uncommon in immunocompetent subjects. The recommended induction treatment is the administration of amphotericin B plus flucytosine combined with resection for lesions ≥3cm. In this paper, we describe an HIV-negative woman diagnosed with a large cryptococcoma in the immediate postpartum period. The lesion was not resected, and due to amphotericin B intolerance, she received an extended course of fluconazole monotherapy. There was no disease recurrence during the 4 years of follow-up. The abrupt onset of her symptoms following delivery suggests that she developed a postpartum immune reconstitution syndrome. This case also demonstrates that in specific situations fluconazole monotherapy can be attempted in immunocompetent patients with cryptococcoma.Key words:Cryptococcus ; Immune reconstitution inflammatory syndrome; Treatment

【 授权许可】

Unknown