S-Space College of Medicine/School of Medicine (의과대학/대학원) Dept. of Medicine (의학과) The Seoul Journal of Medicine The Seoul Journal of Medicine Vol. 12 No.4 (1971)
후두와 종양을 의심하게 하였던 Cryptococcal Meningitis의 1예
Cryptococcal Meningitis Simulating a Posterior Fossa Tumor
- Issue Date
- 서울대학교 의과대학
- Seoul J Med, Vol.12 No.4, pp. 289-292
- Cryptococcal meningitis, also known as Torula
meningitis and yeast meningitis, is caused by an
infection of Cryptococcus Neoformans (Torula Histolytica),
and is the most common form of mycotic
infection of the central nervous system.
Since the first report of this disease by Busse in
1894. many cases have been reported in the literature.
A few cases of cryptococcal meningitis have
been reported ill Korea. A thirteen-years old Korean boy had severe occipital
headache. mental change and decreased vision.
and was admitted to Seoul National University Hospital
on December 14, 1968. On neurological examination.
bilateral papilledema. right 6th nerve palsy.
right-sided hemiparesis and trunkal ataxia were
found. Skull films showed evident suture separation
along with so-called silver-beaten appearance. Carotid
angiogram and ventriculogram showed a marked
symmetrical. bilateral dilatation of ventricular
system suggesting an obstruction of the CSF pathways
in the posterior fossa. Examination of cerebrospinal
fluid showed a slight pleocytosis. elevated protein
and decreased sugar content.
Exploring the posterior fossa, an enlarged cisterna
magna and thickened basal meninges coated with
yellowish necrotic debris or sediments were demonstrated.
A diffuse or more localized opacity of meninges
and obliteration of subarachnoid space over
the cerebellar hemispheres. particularly. the portion
of vallecula. were encountered.
Microscopic findings was acute and chronic inflammatory
changes in different stages with well encapsulated
cryptococcus in loose connective tissue.
On the 10th postoperative day the patient died.
No amphotericin B therapy was done. Postmortem
examination could't be done.