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• Vol.55 No.2
• CLINICA NEUROL, 55: 81−86, 2015
• Vol.55 No.2 contents

Case Report

A case of cryptococcal ventriculitis with slowly progressive gait disturbance and memory impairment as initial symptoms

Nobuo Yamashiro, M.D.¹⁾, Takamura Nagasaka, M.D., Ph.D.¹⁾, Ryusuke Takaki, M.D.¹⁾, Michiaki Miwa, M.D.¹⁾, Kazumasa Shindo, M.D., Ph.D.¹⁾ and Yoshihisa Takiyama, M.D., Ph.D.¹⁾

¹⁾Department of Neurology, Faculty of Medicine, University of Yamanashi

A 54-year-old man was admitted due to progressive gait disturbance and cognitive impairment. On MRI, a hyperintense region was observed in the periventricular white matter on FLAIR imaging, with Gd-enhancement in the choroid plexus and periventricular wall. Cerebrospinal fluid (CSF) examination showed marked abnormalities including a high white blood cell count (WBC, 360 cells/mm³. 83% lymphocytes), an elevated protein level (1,416 mg/dl), a low glucose level (12 mg/dl), and elevated cryptococcal antigen with positive Indian ink staining. Cryptococcal ventriculitis was diagnosed. The patient was initially treated with liposomal amphotericin B, fluconazole, voriconazole, and flucytosine for 38 weeks, followed by administration of itraconazole and fluconazole with some improvement. The brain MRI after one month showed septum formation in the posterior horn, which was suggestive of ventriculitis. Although ventriculitis is rare, we should pay attention to the presence of ventriculitis due to cryptococcal infection in the central nervous system.
Full Text of this Article in Japanese PDF (687K)

(CLINICA NEUROL, 55: 81−86, 2015)
key words: cryptococcal meningoencephalitis, ventriculitis, Cryptococcus neoformans, MRI

(Received: 14-Nov-13)