Two cases of Cryptococcus meningitis presenting as leukoencephalopathy prior to amphotericin therapy

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Abstract

We report two patients with cryptococcal meningitis and combined immunodeficiency with unusual magnetic resonance imaging findings of gadolinium-enhancing white matter lesions, quite different from cryptococcomas and seen prior to anti-fungal treatment. The lesions resembled demyelinating plaques and resolved. In one patient, biopsy of the lesion revealed cryptococci, non-specific inflammatory changes and occasional small perivascular lymphocyte collections, but not demyelination. Leukoencephalopathy, previously rarely observed in Cryptococcal meningitis, was thought to be the sequelae of amphotericin toxicity. Our cases demonstrate cryptococcal meningitis may present with leukoencephalopathy, possibly as an immune response to the organism.

Original languageEnglish
Pages (from-to)350-352
Number of pages3
JournalEuropean Journal of Neurology
Volume14
Issue number3
DOIs
Publication statusPublished - Mar 2007
Externally publishedYes

Keywords

  • Acute disseminated encephalomyelitis
  • Amphotericin
  • Cryptococcus meningitis
  • Demyelinating disease
  • Immunodeficiency
  • Leukoencephalopathy

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