Criptococomas cerebrales en un paciente inmunocompetente: Reporte de un caso

Karina Jarrín-Maisincho, María del Alma Cordovez-Navas, Edmundo Vera-Pérez

Resumen


Se trata de un paciente de 21 años de edad que no acusa antecedentes relevantes para el padecimiento actual que ha sido hospitalizado debido a cefalea, vómitos, dolor retrocular y diplopía. Los resultados de las pruebas paraclínicas (Biometría Hemática completa, serología para virus de inmunodeficiencia humana y el análisis del líquido cefalorraquídeo) y de los estudios de diagnóstico por imágenes no permitieron concluir un diagnóstico específico. El cuadro clínico, en tanto, cursó con un deterioro progresivo del estado de alerta. Fue necesario un análisis de otra muestra de líquido cefalorraquídeo cuyos resultados permitieron concluir el diagnóstico de meningitis criptocócica. Además, un estudio complementario de neuroimagen (imagen por resonancia magnética) ha demostrado lesiones que son cotejables con el diagnóstico. La meningitis criptocócica presente en pacientes inmunocompetentes, como en este caso, es rara y por lo tanto, no se encontraba como parte del abordaje inicial, lo que retrasó su diagnóstico y tratamiento.

Palabras clave: Inmunocompetencia; Líquido cefalorraquídeo; Meningitis criptocócica

 

Cerebral cryptococcomas in an immunocompetent patient: a case report

ABSTRACT

A 21-year-old man who has not significant medical history is admitted to the hospital complaining of a headache, vomiting, retro-orbital pain and diplopia. The results of paraclinical tests (complete blood count, serology for human immunodeficiency virus and analysis of cerebrospinal fluid) and imaging studies did not allow to conclude a specific diagnosis. Meanwhile, the level of consciousness started to decline progressively. It was necessary to analyze another cerebrospinal fluid sample which revealed the diagnosis of cryptococcal meningitis. In addition, a complementary study of neuroimaging (magnetic resonance imaging) showed lesions which confirmed the diagnosis. Cryptococcal meningitis in immunocompetent patients, as in this case, is rare, therefore, it was not part of the initial approach and thereby the diagnosis and treatment were delayed.

Keywords: Cerebrospinal fluid; Cryptococcal meningitis; Immunocompetence


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Referencias


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