Unusual thalamic mass and subsequent gelatinous pseudocysts in an immunocompetent host: A case report
Cryptococcal meningoencephalitis often occurs in an immunocompromised host with several known neurological manifestations including space-occupying lesions, meningitis or meningoencephalitis. Here, we describe a 38-year-old previously healthy durian farm owner with cryptococcoma and subsequent devel...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | IDCases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S221425092200230X |
| _version_ | 1798004697531940864 |
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| author | Apapatra Akiko Watanabe Pasin Hemachudha Wanakorn Rattanawong Thanakit Pongpitakmetha |
| author_facet | Apapatra Akiko Watanabe Pasin Hemachudha Wanakorn Rattanawong Thanakit Pongpitakmetha |
| author_sort | Apapatra Akiko Watanabe |
| collection | DOAJ |
| description | Cryptococcal meningoencephalitis often occurs in an immunocompromised host with several known neurological manifestations including space-occupying lesions, meningitis or meningoencephalitis. Here, we describe a 38-year-old previously healthy durian farm owner with cryptococcoma and subsequent development of cryptococcus gelatinous pseudocyst after receiving high doses of intravenous dexamethasone to treat mass lesion presumed to be a malignant process. An MRI scan of the head demonstrated a 2-cm heterogeneous solitary enhancing cystic lesion at the right thalamus. Progression of neurological deficit and another repeat imaging showing typical appearance of gelatinous pseudocyst. Lumbar puncture found markedly elevated pressure and cryptococcal antigen strongly positive confirming the diagnosis. He was immediately started on amphotericin B and flucytosine for cryptococcus meningoencephalitis with partial improvement in his vision. This report highlights consideration of cryptococcal infection in an immunocompetent host to avoid delays in diagnosis and treatment. |
| first_indexed | 2024-04-11T12:27:30Z |
| format | Article |
| id | doaj.art-f43d6fd47d5746778facd2528edbd195 |
| institution | Directory Open Access Journal |
| issn | 2214-2509 |
| language | English |
| last_indexed | 2024-04-11T12:27:30Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | IDCases |
| spelling | doaj.art-f43d6fd47d5746778facd2528edbd1952022-12-22T04:23:54ZengElsevierIDCases2214-25092022-01-0129e01602Unusual thalamic mass and subsequent gelatinous pseudocysts in an immunocompetent host: A case reportApapatra Akiko Watanabe0Pasin Hemachudha1Wanakorn Rattanawong2Thanakit Pongpitakmetha3Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; Department of Medicine, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi 11120, ThailandThai Red Cross Emerging Infectious Diseases Health Science Centre, World Health Organization Collaborating Centre for Research and Training on Viral Zoonoses, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; Division of Neurology, Department of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; Correspondence to: Thai Red Cross Emerging Infectious Diseases Health Science Centre, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.Division of Neurology, Department of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; Department of Medicine, Faculty of Medicine, King Mongkut's Institute of Technology Ladkrabang, Bangkok, ThailandDivision of Neurology, Department of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; Department of Pharmacology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; Chula Neuroscience Center, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, ThailandCryptococcal meningoencephalitis often occurs in an immunocompromised host with several known neurological manifestations including space-occupying lesions, meningitis or meningoencephalitis. Here, we describe a 38-year-old previously healthy durian farm owner with cryptococcoma and subsequent development of cryptococcus gelatinous pseudocyst after receiving high doses of intravenous dexamethasone to treat mass lesion presumed to be a malignant process. An MRI scan of the head demonstrated a 2-cm heterogeneous solitary enhancing cystic lesion at the right thalamus. Progression of neurological deficit and another repeat imaging showing typical appearance of gelatinous pseudocyst. Lumbar puncture found markedly elevated pressure and cryptococcal antigen strongly positive confirming the diagnosis. He was immediately started on amphotericin B and flucytosine for cryptococcus meningoencephalitis with partial improvement in his vision. This report highlights consideration of cryptococcal infection in an immunocompetent host to avoid delays in diagnosis and treatment.http://www.sciencedirect.com/science/article/pii/S221425092200230XCryptococcusGelatinous pseudocystMeningoencephalitisCase report |
| spellingShingle | Apapatra Akiko Watanabe Pasin Hemachudha Wanakorn Rattanawong Thanakit Pongpitakmetha Unusual thalamic mass and subsequent gelatinous pseudocysts in an immunocompetent host: A case report IDCases Cryptococcus Gelatinous pseudocyst Meningoencephalitis Case report |
| title | Unusual thalamic mass and subsequent gelatinous pseudocysts in an immunocompetent host: A case report |
| title_full | Unusual thalamic mass and subsequent gelatinous pseudocysts in an immunocompetent host: A case report |
| title_fullStr | Unusual thalamic mass and subsequent gelatinous pseudocysts in an immunocompetent host: A case report |
| title_full_unstemmed | Unusual thalamic mass and subsequent gelatinous pseudocysts in an immunocompetent host: A case report |
| title_short | Unusual thalamic mass and subsequent gelatinous pseudocysts in an immunocompetent host: A case report |
| title_sort | unusual thalamic mass and subsequent gelatinous pseudocysts in an immunocompetent host a case report |
| topic | Cryptococcus Gelatinous pseudocyst Meningoencephalitis Case report |
| url | http://www.sciencedirect.com/science/article/pii/S221425092200230X |
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