oa Central African Journal of Medicine - Cryptococcus neoformans meningitis

Volume 31, Issue 4
  • ISSN : 0008-9176



A 32 year-old man presented with paraplegia and double incontinence due to spinal compression. Histology of tissue obtained at laminectomy showed Cryptococcus neoformans. The organism was subsequently cultured from the cerebrospinal fluid although the patient had no symptoms of meningitis. Therapy with Amphotericin B and 5-Fluorocytosin was attempted but the patient died of pneumonia. Review of his case suggested the infection had started 12 years previously when he was admitted with recurrent meningitis, not responding to antibiotics, and a persistent coin lesion in his left lung. Cryptococcosis, caused by the ubiquitous yeast Cryptococcus neoformans is a pulmonary infection with propensity for systemic spread, usually to the nervous system Presentation as a space occupying lesion is well descriptionbed, including 2 cases previously reported from Zimbabwe. It also mimics tuberculous meningitis although it tends to have a more chronic course. There are scattered reports of untreated cases surviving over many years, and even one of apparent spontaneous cure. There have been previous reports from Zimbabwe, and this one highlights the chronic nature of the infection, its tendency to cause space occupying granuloma and the difficulties of treatment.

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