Abstract
We report an atypical feature of neuromeningeal cryptococcosis presenting as spinal cystic arachnoiditis and cerebellar cryptococcoma in a child treated for pontine glioma. In November 2003, we diagnosed a pontine glioma in a six-year-old female child. She was initially treated with radiotherapy (54Gy for six weeks) and dexamethasone until July 2006. From January 2004 to September 2006, the patient received 30 cycles of chemotherapy including vincristine 1.5mg/m(2) Day 1, carboplatin 150mg/m(2) Day 1, and temozolomide 150mg/m(2) Days 2-6 every 28 days. In October 2006, the patient suffered spontaneous acute low back pain radiating into both lower limbs revealing lumbar cystic arachnoiditis and cerebellar cryptococcoma. The cerebrospinal fluid (CSF) sample showed lymphocytic pleocytosis and Cryptococcus neoformans; glucose and protein levels were low. First-line medical treatment including liposomal amphotericin B, then fluconazole effectively decreased the pain. However, in February 2007, she presented with cauda equina syndrome and the spinal MRI showed that the lumbar cyst had increased in size. The patient underwent a lumbar laminectomy and cyst removal. Histology confirmed the arachnoiditis with no cancer cells or pathogeni...Continue Reading
References
May 1, 1990·Pediatric Neurology·W C WoodallM S Gelfand
Feb 1, 1968·Journal of Neurology, Neurosurgery, and Psychiatry·S Davidson
May 1, 1982·Annals of Neurology·S C SteinP Farmer
Sep 1, 1999·The Journal of Hospital Infection·C H LuY C Chuang
Jul 31, 2001·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·P G PappasW E Dismukes
Mar 11, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Sara A MirzaRana A Hajjeh
Jun 14, 2003·Orthopaedic Nursing·Michael H Wright, Leann C Denney
Aug 29, 2003·Journal of the International Association of Physicians in AIDS Care : JIAPAC·Alcides TroncosoJavier Bava
Aug 25, 2004·Neurology·Margaret LaneJohn Archer
Mar 1, 2005·Surgical Neurology·Arvind DubeyAnil Nanda
Apr 22, 2005·European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society·Ronald van Toorn, Helena Rabie
Jul 8, 2005·Journal of Clinical Microbiology·M Francisca ColomJosep M Torres-Rodríguez
Nov 1, 2005·Clinical Neurology and Neurosurgery·Abhishek AgrawalAnshu Rohtagi
Nov 8, 2005·Journal of Clinical Microbiology·Spinello AntinoriCarlo Parravicini
Dec 21, 2005·La Revue de médecine interne·M RevestB Grosbois
May 9, 2006·Clinical Radiology·C E Offiah, I W Turnbull
Feb 28, 2007·Acta Clinica Belgica·Y CoppensD Vogelaers
Mar 1, 2007·Neurosurgery·Charles W KanalyD Cory Adamson