Department of Neurological Sciences, "Federico II" University of Naples, Italy.
J Neurol Sci. 2013 Nov 15;334(1-2):180-2. doi: 10.1016/j.jns.2013.08.010. Epub 2013 Aug 15.
Central nervous system cryptococcal infections usually manifests as meningitis, meningoencephalitis, encephalitis or ventriculitis. Cryptococcal choroid plexus inflammation is a particularly rare entity most often presenting with signs and symptoms of intracranial hypertension, hydrocephalus or meningitis due to a delayed diagnosis. Herein we reported the case of a 63-year-old immunocompetent woman with a history of temporal lobe epilepsy and behavioral disorders. Magnetic resonance imaging (MRI) and fluorodeoxyglucose positron emission tomographic (FDG-PET) images revealed atypical cryptococcal choroid plexitis with surrounding bitemporal edema without features of meningitis, intraparenchymal cryptococcoma or hydrocephalus. The patient underwent serial MRI and FDG-PET images performed before and after antifungal therapy that caused a marked clinical improvement. Our case also suggests a potential role of FDG-PET in the monitoring antifungal therapeutic efficacy.
中枢神经系统隐球菌感染通常表现为脑膜炎、脑膜脑炎、脑炎或脑室炎。隐球菌性脉络丛炎是一种特别罕见的疾病实体，由于诊断延迟，最常表现为颅内高压、脑积水或脑膜炎的症状和体征。在此，我们报告了一例 63 岁免疫功能正常的女性患者，她有颞叶癫痫和行为障碍病史。磁共振成像（MRI）和氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）图像显示典型的隐球菌性脉络丛炎，伴有双侧颞叶周围水肿，无脑膜炎、脑实质隐球菌瘤或脑积水的特征。该患者在接受抗真菌治疗前后进行了连续的 MRI 和 FDG-PET 检查，结果显示临床症状显著改善。我们的病例还提示 FDG-PET 在监测抗真菌治疗效果方面具有潜在作用。
