Puerperal brain cryptococcoma in an HIV-negative woman successfully treated with fluconazole: a case report
AUTOR(ES)
Hagan, José Edward, Dias, Jesângeli Sousa, Villasboas-Bisneto, José Caetano, Falcão, Melissa Barreto, Ko, Albert Icksang, Ribeiro, Guilherme Sousa
FONTE
Rev. Soc. Bras. Med. Trop.
DATA DE PUBLICAÇÃO
2014-04
RESUMO
Cryptococcus spp. cerebral abscesses are uncommon in immunocompetent subjects. The recommended induction treatment is the administration of amphotericin B plus flucytosine combined with resection for lesions ≥3cm. In this paper, we describe an HIV-negative woman diagnosed with a large cryptococcoma in the immediate postpartum period. The lesion was not resected, and due to amphotericin B intolerance, she received an extended course of fluconazole monotherapy. There was no disease recurrence during the 4 years of follow-up. The abrupt onset of her symptoms following delivery suggests that she developed a postpartum immune reconstitution syndrome. This case also demonstrates that in specific situations fluconazole monotherapy can be attempted in immunocompetent patients with cryptococcoma.
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