Cryptococcus spp. cerebral abscesses are uncommon in immunocompetent subjects. The recommended induction treatment is the administration of amphotericin B plus flucytosine combined with resection for lesions ≥3cm. In this paper, we describe an HIV-negative woman diagnosed with a large cryptococcoma in the immediate postpartum period. The lesion was not resected, and due to amphotericin B intolerance, she received an extended course of fluconazole monotherapy. There was no disease recurrence during the 4 years of follow-up. The abrupt onset of her symptoms following delivery suggests that she developed a postpartum immune reconstitution syndrome. This case also demonstrates that in specific situations fluconazole monotherapy can be attempted in immunocompetent patients with cryptococcoma.
Hagan, J. E., Dias, J. S., Villasboas-Bisneto, J. C., Falcão, M. B., Ko, A. I., & Ribeiro, G. S. (2014). Puerperal brain cryptococcoma in an HIV-negative woman successfully treated with fluconazole: A case report. Revista Da Sociedade Brasileira de Medicina Tropical, 47(2), 254–256. https://doi.org/10.1590/0037-8682-0215-2013