Puerperal brain cryptococcoma in an HIV-negative woman

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-06-04T18:57:23Z No. of bitstreams: 1 Hagan JE Puerperal brain....pdf: 1140839 bytes, checksum: 3c06df73ae5d23f154cfd27b464cbab1 (MD5)Made available in DSpace on 2014-06-04T18:57:23Z (GMT). No. of bitstreams: 1 Hagan JE Puerperal brain....pdf: 1140839 bytes, checksum: 3c06df73ae5d23f154cfd27b464cbab1 (MD5) Previous issue date: 2014Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, CT, USA / Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilHospital Couto Maia. Secretaria de Saúde do Estado da Bahia. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilHospital Couto Maia. Secretaria de Saúde do Estado da Bahia. Salvador, BA, BrasilYale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, CT, USA / Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, BrasilCryptococcus spp. cerebral abscesses are uncommon in immunocompetent subjects. The recommended induction treatment is the administration of amphotericin B plus fl ucytosine 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 fl uconazole 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 specifi c situations fl uconazole monotherapy can be attempted in immunocompetent patients with cryptococcom