Cerebral cryptococcoma successfully treated by isavuconazole in an immunocompetent patient: A case report

Ramanzini, Luís Guilherme; Medeiros, Sara Diógenes Peixoto de; Lima, Lara Maria Fujita Vieira; Santos, Marcéu Veríssimo Ramos dos; Herbster, Elizeu Alves; Araujo, Guilherme Dourado Aragão Sá; Araújo, Victor Oliveira; Braga, Jessica Maria Bezerra; Nones, Diogo Pasquali; Santos, Júlio César Claudino dos

doi:10.1016/j.radcr.2022.11.011

Cited by 6 publications

(4 citation statements)

References 39 publications

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“…Ramanzini et al 5 analyzed 29 cases of CNS cryptococcoma reported in the literature. Cases included 19 males and 10 females with a mean age of 43 years.…”

Section: Discussionmentioning

confidence: 99%

“…For these reasons, initial diagnoses were gliomas and metastases. 5 Chastain et al 6 also provided a review of 47 cerebral cryptococcomas based on a scoping review using PubMed and Web of Science ( Table 2 ).…”

Section: Discussionmentioning

confidence: 99%

“…Although it is acknowledged that cryptococcosis frequently affects immunocompromised patients, this infectious entity can occur in healthy patients. 1 Ramanzini et al 5 analyzed 29 cases of CNS cryptococcoma reported in the literature. Cases included 19 males and 10 females with a mean age of 43 years.…”

Section: Discussionmentioning

confidence: 99%

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Pituitary cryptococcoma in an immunocompetent patient with panhypopituitarism: illustrative case

Maciel-Ramos,

Castillejo-Adalid,

Rodríguez-Hernández

et al. 2023

Journal of Neurosurgery: Case Lessons

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BACKGROUND Cryptococcosis is the most common mycosis of the central nervous system. It may develop in immunocompetent and immunocompromised patients, the latter representing most cases. The most common presentation of the disease is meningitis, whereas intra-axial lesions in the form of cryptococcoma are less frequent with a greater tendency to present in immunocompetent patients. The presentation of pituitary cryptococcoma is exceptional. To the best of the authors’ knowledge, there is only one case published in the medical literature. OBSERVATIONS The authors present the case of a 30-year-old male without a relevant medical history. He was referred to our center with a pituitary mass on magnetic resonance imaging and panhypopituitarism. The patient underwent endonasal endoscopic transsphenoidal tumor resection, and a histopathological diagnosis of pituitary cryptococcoma was made. Medical management included fluconazole and intravenous amphotericin. LESSONS This case underscores the neurosurgical and medical management of an exceptional clinical presentation of pituitary cryptococcoma in an immunocompetent patient. To the best of the authors’ knowledge, there is only one case published in the medical literature. This case provides an invaluable review of the clinical, imaging, and therapeutic considerations regarding this exceptional clinical entity.

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“…Ramanzini et al 5 analyzed 29 cases of CNS cryptococcoma reported in the literature. Cases included 19 males and 10 females with a mean age of 43 years.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pituitary cryptococcoma in an immunocompetent patient with panhypopituitarism: illustrative case

Maciel-Ramos,

Castillejo-Adalid,

Rodríguez-Hernández

et al. 2023

Journal of Neurosurgery: Case Lessons

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“…Voriconazole has good CNS penetration, and its effect was similar to adjunctive fluconazole as part of amphotericin-based combination therapy [ 45 , 46 ]. Isavuconazole, similarly has CNS penetration with some reports of use in case reports [ 47 – 49 ], yet, isavuconazole is not readily available in most low- and middle-income country settings. Posaconazole is also of interest [ 50 ].…”

Section: Treatmentmentioning

confidence: 99%

Complex Decisions in HIV-Related Cryptococcosis: Addressing Second Episodes of Cryptococcal Meningitis

Musubire,

Kagimu,

Mugabi

et al. 2024

Curr HIV/AIDS Rep

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Purpose of Review This review highlights the difficulties in diagnosing and treating persons with a prior history of cryptococcal meningitis who improve but suffer from a recurrence of symptoms. This scenario is well known to those who frequently care for patients with cryptococcal meningitis but is not well understood. We highlight major gaps in knowledge. Recent Findings We recently summarized our experience with 28 persons with paradoxical immune reconstitution inflammatory syndrome (IRIS) and 81 persons with microbiological relapse. CD4 count and cerebrospinal fluid white blood cell count were higher in IRIS than relapse but neither was reliable enough to routinely differentiate these conditions. Summary Second-episode cryptococcal meningitis remains a difficult clinical scenario as cryptococcal antigen, while excellent for initial diagnosis has no value in differentiating relapse of infection from other causes of recurrent symptoms. Updated research definitions are proposed and rapid, accurate diagnostic tests are urgently needed.

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Amphotericin-B

2023

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Cerebral cryptococcoma successfully treated by isavuconazole in an immunocompetent patient: A case report

Cited by 6 publications

References 39 publications

Pituitary cryptococcoma in an immunocompetent patient with panhypopituitarism: illustrative case

Pituitary cryptococcoma in an immunocompetent patient with panhypopituitarism: illustrative case

Complex Decisions in HIV-Related Cryptococcosis: Addressing Second Episodes of Cryptococcal Meningitis

Amphotericin-B

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