Treatment of indolent, nonencapsulated cryptococcal meningitis associated with hydrocephalus
Infection with cryptococcal meningitis is uncommon in immunocompetent patients. The major virulence factor is the polysaccharide capsule, while nonencapsulated mutants are generally considered nonpathogenic. The authors present a case of hydrocephalus caused by meningitis from an indolent, nonencaps...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2012-01-01
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| Series: | Clinics and Practice |
| Subjects: | |
| Online Access: | https://www.clinicsandpractice.org/index.php/cp/article/view/329 |
| _version_ | 1828109818350534656 |
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| author | Sarah T. Garber Paul L. Penar |
| author_facet | Sarah T. Garber Paul L. Penar |
| author_sort | Sarah T. Garber |
| collection | DOAJ |
| description | Infection with cryptococcal meningitis is uncommon in immunocompetent patients. The major virulence factor is the polysaccharide capsule, while nonencapsulated mutants are generally considered nonpathogenic. The authors present a case of hydrocephalus caused by meningitis from an indolent, nonencapsulated Cryptococcus sp. requiring placement and multiple revisions of a ventriculoperitoneal shunt (VPS). The patient presented with progressively worsening occipital headaches. Computed tomography and magnetic resonance imaging showed significant hydrocephalus with no apparent cause. Her symptoms initially resolved after placement of a VPS, but returned four months later. Cultures of the shunt tubing and cerebrospinal fluid (CSF) showed no bacterial infection. When the symptoms failed to resolve, CSF fungal culture revealed Cryptococcus-like yeast, although the organisms were nonencapsulated, and the cryptococcal antigen was negative. After antibiotic therapy, the symptoms resolved. The unusual clinical presentation delayed the diagnosis, highlighting the importance of understanding the detection, diagnosis, and treatment of meningeal infections caused by C. neoformans. |
| first_indexed | 2024-04-11T11:10:11Z |
| format | Article |
| id | doaj.art-ea14d61ec6804816983735fb70c38f02 |
| institution | Directory Open Access Journal |
| issn | 2039-7275 2039-7283 |
| language | English |
| last_indexed | 2024-04-11T11:10:11Z |
| publishDate | 2012-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Clinics and Practice |
| spelling | doaj.art-ea14d61ec6804816983735fb70c38f022022-12-22T04:27:51ZengMDPI AGClinics and Practice2039-72752039-72832012-01-012110.4081/cp.2012.e22156Treatment of indolent, nonencapsulated cryptococcal meningitis associated with hydrocephalusSarah T. Garber0Paul L. Penar1Department of Neurosurgery, College of Medicine, The University of Vermont, Burlington, VermontDepartment of Neurosurgery, College of Medicine, The University of Vermont, Burlington, VermontInfection with cryptococcal meningitis is uncommon in immunocompetent patients. The major virulence factor is the polysaccharide capsule, while nonencapsulated mutants are generally considered nonpathogenic. The authors present a case of hydrocephalus caused by meningitis from an indolent, nonencapsulated Cryptococcus sp. requiring placement and multiple revisions of a ventriculoperitoneal shunt (VPS). The patient presented with progressively worsening occipital headaches. Computed tomography and magnetic resonance imaging showed significant hydrocephalus with no apparent cause. Her symptoms initially resolved after placement of a VPS, but returned four months later. Cultures of the shunt tubing and cerebrospinal fluid (CSF) showed no bacterial infection. When the symptoms failed to resolve, CSF fungal culture revealed Cryptococcus-like yeast, although the organisms were nonencapsulated, and the cryptococcal antigen was negative. After antibiotic therapy, the symptoms resolved. The unusual clinical presentation delayed the diagnosis, highlighting the importance of understanding the detection, diagnosis, and treatment of meningeal infections caused by C. neoformans.https://www.clinicsandpractice.org/index.php/cp/article/view/329Cryptococcus neoformanshydrocephalusventriculoperitoneal shuntmeningitis. |
| spellingShingle | Sarah T. Garber Paul L. Penar Treatment of indolent, nonencapsulated cryptococcal meningitis associated with hydrocephalus Clinics and Practice Cryptococcus neoformans hydrocephalus ventriculoperitoneal shunt meningitis. |
| title | Treatment of indolent, nonencapsulated cryptococcal meningitis associated with hydrocephalus |
| title_full | Treatment of indolent, nonencapsulated cryptococcal meningitis associated with hydrocephalus |
| title_fullStr | Treatment of indolent, nonencapsulated cryptococcal meningitis associated with hydrocephalus |
| title_full_unstemmed | Treatment of indolent, nonencapsulated cryptococcal meningitis associated with hydrocephalus |
| title_short | Treatment of indolent, nonencapsulated cryptococcal meningitis associated with hydrocephalus |
| title_sort | treatment of indolent nonencapsulated cryptococcal meningitis associated with hydrocephalus |
| topic | Cryptococcus neoformans hydrocephalus ventriculoperitoneal shunt meningitis. |
| url | https://www.clinicsandpractice.org/index.php/cp/article/view/329 |
| work_keys_str_mv | AT sarahtgarber treatmentofindolentnonencapsulatedcryptococcalmeningitisassociatedwithhydrocephalus AT paullpenar treatmentofindolentnonencapsulatedcryptococcalmeningitisassociatedwithhydrocephalus |