CNS cryptococcosis: unusual aspects.

Eleven patients with CNS cryptococcal infection are reviewed. The most prominent symptom was headache, present in all patients. The clinical manifestations were the direct result of the meningitis itself or a consequence of intracranial cryptococcal granulomata or hydrocephalus, these latter 2 complications being demonstrable on CT head scan. In the 2 patients who also had MRI scans, additional parenchymal lesions were revealed which had not been detected by CT. Combined amphotericin B and 5-fluorocytosine therapy was the treatment of choice, but in 3 patients fluconazole was also used. Chronic oral therapy with this agent has maintained a good clinical response in one patient who failed to respond to traditional antifungal therapy.