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

Research output: Contribution to journalArticle

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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

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Cryptococcus neoformans
Ulcerative Colitis
Cryptococcus
Spinal Nerve Roots
Infection
Flucytosine
Dysuria
Meninges
Subarachnoid Space
Meningoencephalitis
Spinal Cord Diseases
Azathioprine
Immunocompromised Host
Amphotericin B
Erectile Dysfunction
Prednisolone
Meningitis
Nervous System
Lower Extremity
Autopsy

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Myeloradiculitis caused by Cryptococcus neoformans infection in a patient with ulcerative colitis : A neuropathological study. / Murai, Hiroyuki; Tokunaga, Hideaki; Kubo, Ikuko; Kawajiri, Masakazu; Iwaki, Toru; Taniwaki, Takayuki; Kira, Jun ichi.

In: Journal of the Neurological Sciences, Vol. 247, No. 2, 25.09.2006, p. 236-238.

Research output: Contribution to journalArticle

Murai, Hiroyuki ; Tokunaga, Hideaki ; Kubo, Ikuko ; Kawajiri, Masakazu ; Iwaki, Toru ; Taniwaki, Takayuki ; Kira, Jun ichi. / Myeloradiculitis caused by Cryptococcus neoformans infection in a patient with ulcerative colitis : A neuropathological study. In: Journal of the Neurological Sciences. 2006 ; Vol. 247, No. 2. pp. 236-238.
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