Myeloradiculitis caused by Cryptococcus neoformans infection in a patient with ulcerative colitis: A neuropathological study

Hiroyuki Murai, Hideaki Tokunaga, Ikuko Kubo, Masakazu Kawajiri, Toru Iwaki, Takayuki Taniwaki, Jun ichi Kira

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10 Citations (Scopus)

Abstract

Meningitis is the most common feature of cryptococcal infection of the nervous system. We herein describe the case of a 48-year-old man with fulminant cryptococcal myeloradiculitis, whose initial symptoms were impotence, dysuria and weakness of the lower extremities. He had been administered prednisolone and azathioprine for 7 years for ulcerative colitis before onset of myeloradiculitis. He finally developed meningoencephalitis and died 2 months after onset despite treatment with amphotericin B and flucytosine. Post-mortem examination revealed numerous infiltrations of cryptococci in the spinal roots as well as in the meninges and subarachnoid space. Inflammatory cells and cryptococci had infiltrated the vessel walls in the spinal cord, and this was accompanied by necrotizing myelopathy. Myeloradiculitis is rare in cryptococcal infection, and this is the first case report to demonstrate direct cryptococcal infection in the spinal roots. Cryptococcal infection should be considered while managing myeloradiculopathy of unknown etiology, especially in immunocompromised patients.

Original languageEnglish
Pages (from-to)236-238
Number of pages3
JournalJournal of the Neurological Sciences
Volume247
Issue number2
DOIs
Publication statusPublished - Sep 25 2006

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

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