Clinical features of space occupying lesion due to fungal infections mimicking brain tumor: Case report

Abstract

Diagnosis and treatment of masses due to fungal infection of the central nervous system is often difficult. Radiologic features are often non-specific and are often confused with malignant lesions so that a new diagnosis can be made by histological examination after resection. The combination of medical and surgical treatment of fungal infections of the central nervous system is optimal in shortening the duration of antifungal therapy, providing a definitive diagnosis and improving patient outcome. A 57-year-old male patient was conscious with complaints of weakness in the left half of the body, progressive chronic headache for 6 months and seizures, with physical examination results in the form of papilledema dextra, paresis N VI dextra et sinistra, paresis N VII S supranuclear, hemiparesis flaccid of left with grade 2/3, chronic progressive cephalgia and with a history of partial seizures become secondary common. Non-reactive HIV, CT scan of the head supporting a primary brain tumor with suspicion of intratumoral bleeding and cerebral edema. After surgery, histopathological examination results suitable for cerebral abscess, leading to fungal infection that is Cryptococcus neoformans. The patient was treated with 600 milligrams of Fluconazole every 12 hours intraoral for 6 months, the complaints improved and the head MRI was evaluated as normal. Conclusions. Diagnosis of fungal infection is still a challenge. The combination of surgical medical therapy in a mass fungal infection of the central nervous system is optimal in shortening the duration of antifungal treatment, providing a definitive diagnosis, and improving patient outcomes.