Criptococoma cerebral e pulmonar em paciente imunocompetente: relato de caso

Resumo

Neurocriptococose é uma infecção fúngica do sistema nervoso central e sua principal apresentação clínica é a meningoencefalite. Lesões sólidas com aspecto tumoral, denominadas criptococoma, podem manifestar-se principalmente em imunodeprimidos. É relatado caso de paciente jovem, imunocompetente, com lesão tumoral frontal direita com grande efeito de massa e lesão menor em lobo occipital esquerdo, assim como lesão tumoral em pulmão direito. A paciente e seus cuidadores concordaram e autorizaram a publicação do caso. Foi feita revisão da literatura quanto à epidemiologia, tratamento e prognóstico. A paciente foi tratada com anfotericina B lipossomal e submetida à ressecção cirúrgica das lesões cerebrais e pulmonar, em tempos distintos, com bom desfecho clínico. A criptococose é infecção comum que pode acometer indivíduos tanto imunocomprometidos quanto imunocompetentes. Embora a meningoencefalite seja a forma mais comum de acometimento do SNC, existem outras formas mais raras como criptococoma cerebral. Há evidência de que a abordagem cirúrgica das lesões expansivas é benéfica e recomendada.

Abstract

Neurocryptococcosis is a fungal infection of the central nervous system and its major clinical manifestation is meningoencephalitis. Solid tumor-like lesions, referred as cryptococcoma, usually occurs in immunocompromised patients. This paper reports a young immunocompetent female with a tumor-like lesion on the right frontal region and another one on the left occipital lobe, as well as a tumor lesion on her right lung. The patient and her caregivers have agreed and authorized the publishing of the case. Literature review was made regarding the epidemiology, treatment and prognosis. The patient was treated with anfotericine B and underwent surgical resection of the brain and lung lesions, at different times, with good clinical outcome. C. neoformans is a common fungal infection that can affect both immunocompetent and immunocompromised individuals. Although meningoencephalitis is the most common presentation of CNS involvement, there are other rarer forms such as cerebral cryptococcoma. There is evidence that the surgical treatment of mass lesions is beneficial and recommended.

Palavras-Chave

cérebro - infecção - criptococose - neurocirurgia

Keywords

brain - infection - cryptococcosis - neurosurgery

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