Diagnosis of cryptococcal encephalitis in a patient with mature B-cell lymphoblastic leukemia

• Main Authors: Lev Nikolaevich Gotman, Galina Aleksandrovna Yatsyk, Vladimir Ivanovich Vorob'ev, L N Gotman, G A Yatsyk, V I Vorobyev
• Format: Article
• Language: Russian
• Published: "Consilium Medicum" Publishing house 2010-03-01
• Series: Терапевтический архив
• Subjects: cryptococcal encephalitis; meningitis
• Online Access: https://ter-arkhiv.ru/0040-3660/article/view/33409

Fungal meningoencephalitides are one of the most menacing infectious complications in hematologic cancer patients in the presence of myelotoxic agranulocytosis. Due to diagnostic difficulties, mortality in these cases can be as high as 100%. The causative agent of cryptococcosis is Cryptococcus neoformans; damage to the brain arachnoid membranes and substance is diagnosed in 70-90% of cases. Unlike bacterial meningitis, the meningeal symptoms typical of cryptococcal meningoencephalitis are not characteristic. The paper gives a case of successful treatment for cryptococcal meningoencephalitis in the presence of agranulocytosis, the diagnosis of which is based on the detection of abnormal MR signal foci by magnetic resonance imaging and identification of the cryptococcal antigen - glucuronoxylomannan in spinal fluid.