criptococcal meningitis

Immune reconstitution inflammatory syndrome (IRIS) in HIV-1-infected patients is associated with an exaggerated inflammatory response against an opportunistic infection during highly active antiretroviral therapy. The only review on IRIS associated with Criptococcus neoformans reported 21 episodes including lymphadenitis, necrotizing pneumonitis, breast and cutaneous abscess, and cryptococcomas. To our knowledge this is the first report of IRIS associated with previous meningeal criptococcal infection which required neurosurgical intervention with placement of a ventriculo-peritoneal shunt to drain a CSF cyst formed by exclusion of the temporal horn of the right lateral ventricle...

INTRODUCTION: Central nervous system cryptococcosis is an important cause of morbidity and mortality in immunocompromised patients; nevertheless, its presentation in immuno-spared patients is extremely rare, giving rise to a hole different spectrum, since it is manifested like granulomatous masses named cryptococomas. AIM. To describe an intracerebral case of cryptococcoma in an immuno-spared woman in the Hospital Universitario de Santander and to discuss the most relevant topics of this pathology...

The objective of high activity antiretroviral therapy (HAART) in patients with AIDS, is to obtain immune restoration. This means a reduction of the viral load and restitution of the CD4 cell count. A decreased rate of HIV replication improves both the number and function of CD4 cells. Nevertheless, this treatment sometimes results in the reappearance of previous symptoms from treated conditions due to opportunistic infections (ie: tuberculosis, criptococcosis, hepatitis, Pneumocystis jirovesi, toxoplasmosis, etc) or non infectious condition such as sarcoidosis, Graves disease or Kaposi sarcoma...

The neurological complications of HIV contribute importantly to patient morbidity and mortality. Major common AIDS-related CNS diseases are ADC, metabolic encephalopaties, CMV encephalitis, TE, PCNSL, PML, criptococcal meningitis, and aseptic meningitis. After HAART, declines in incidence and improved outcome of several HIV-1 related opportunistic infections, including CNS-ADIs have been reported. The differential diagnosis of CNS complications of AIDS is routinely established according to temporal evolution, clinical data, and neuroradiological imaging...