[Central nervous cryptococcosis giving rise to ascites after ventriculo-peritoneal shunting--a case report]. 1988

S Niikawa, and A Hara, and H Nokura, and T Uno, and A Ohkuma, and H Yamada
Department of Neurosurgery, Prefectural Gifu Hospital, Japan.

The ascites retention as a complication after ventriculo-peritoneal shunting (V-P shunt) is very rare. In this paper, a case of central nervous cryptococcosis giving rise to ascites after a V-P shunt is presented. A 45-year-old female was referred to Prefectural Gifu Hospital complaining of nausea and disturbance of recent memory. She had no remarkable medical history. CT scan films on admission showed enlarged ventricles except for the fourth ventricle, indicating an obstructed hydrocephalus. Lumbar cerebrospinal fluid (CSF) examinations revealed an increase in cell counts (mostly lymphocytes) and protein content, and positive Pandy and Nonne-Apelt reactions. Based on this information, it was tentatively suggested that she had a certain infection in the central nervous system such as mycosis or tuberculosis etc. Continuous ventricular drainage was performed for about three weeks. During this period, several lumbar and ventricular CSF cultures were negative. Therefore, a V-P shunt operation was performed. However, about seven weeks after the V-P shunt, she developed abdominal distention without any peritoneal signs. Abdominal CT scan films showed an abnormal ascites retention. Laboratory tests revealed positive CRP and increased ESR values. Again, it was suggested that she had not only a central nervous but also a peritoneal infection giving rise to ascites. From samples of ventricular CSF and ascites, cryptococcus neoformans was cultured. The lumbar CSF revealed positive latex agglutination titer for cryptococcal antigen, although the culture was negative. The ascites examination revealed an increase in cell counts (mostly lymphocytes) and protein content, and positive Rivalta and Runneberg reactions.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D008825 Miconazole An imidazole antifungal agent that is used topically and by intravenous infusion. Brentan,Dactarin,Miconasil Nitrate,Miconazole Nitrate,Monistat,R-14,889,Nitrate, Miconasil,Nitrate, Miconazole,R 14,889,R14,889
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D001927 Brain Diseases Pathologic conditions affecting the BRAIN, which is composed of the intracranial components of the CENTRAL NERVOUS SYSTEM. This includes (but is not limited to) the CEREBRAL CORTEX; intracranial white matter; BASAL GANGLIA; THALAMUS; HYPOTHALAMUS; BRAIN STEM; and CEREBELLUM. Intracranial Central Nervous System Disorders,Brain Disorders,CNS Disorders, Intracranial,Central Nervous System Disorders, Intracranial,Central Nervous System Intracranial Disorders,Encephalon Diseases,Encephalopathy,Intracranial CNS Disorders,Brain Disease,Brain Disorder,CNS Disorder, Intracranial,Encephalon Disease,Encephalopathies,Intracranial CNS Disorder
D002557 Cerebrospinal Fluid Shunts Tubes inserted to create communication between a cerebral ventricle and the internal jugular vein. Their emplacement permits draining of cerebrospinal fluid for relief of hydrocephalus or other condition leading to fluid accumulation in the ventricles. Cerebrospinal Fluid Shunt,Shunt, Cerebrospinal Fluid,Shunts, Cerebrospinal Fluid
D003453 Cryptococcosis Fungal infection caused by genus CRYPTOCOCCUS. C gattii Infection,C neoformans Infection,C. gattii Infection,C. neoformans Infection,Cryptococcus Infection,Cryptococcus Infections,Cryptococcus gattii Infection,Torulosis,Cryptococcus neoformans Infection,C gattii Infections,C neoformans Infections,C. gattii Infections,C. neoformans Infections,Cryptococcoses,Cryptococcus gattii Infections,Cryptococcus neoformans Infections,Infection, C gattii,Infection, C neoformans,Infection, C. gattii,Infection, C. neoformans,Infection, Cryptococcus,Infection, Cryptococcus gattii,Infection, Cryptococcus neoformans,Infections, C gattii,Infections, C. neoformans,Toruloses
D005260 Female Females
D005437 Flucytosine A fluorinated cytosine analog that is used as an antifungal agent. 5-Fluorocytosine,Alcobon,Ancobon,Ancotil
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006849 Hydrocephalus Excessive accumulation of cerebrospinal fluid within the cranium which may be associated with dilation of cerebral ventricles, INTRACRANIAL HYPERTENSION; HEADACHE; lethargy; URINARY INCONTINENCE; and ATAXIA. Communicating Hydrocephalus,Congenital Hydrocephalus,Obstructive Hydrocephalus,Post-Traumatic Hydrocephalus,Aqueductal Stenosis,Cerebral Ventriculomegaly,Fetal Cerebral Ventriculomegaly,Hydrocephalus Ex-Vacuo,Hydrocephaly,Aqueductal Stenoses,Cerebral Ventriculomegalies,Cerebral Ventriculomegalies, Fetal,Cerebral Ventriculomegaly, Fetal,Fetal Cerebral Ventriculomegalies,Hydrocephalus Ex Vacuo,Hydrocephalus Ex-Vacuos,Hydrocephalus, Communicating,Hydrocephalus, Congenital,Hydrocephalus, Obstructive,Hydrocephalus, Post-Traumatic,Post Traumatic Hydrocephalus,Stenoses, Aqueductal,Stenosis, Aqueductal,Ventriculomegalies, Cerebral,Ventriculomegalies, Fetal Cerebral,Ventriculomegaly, Cerebral,Ventriculomegaly, Fetal Cerebral
D001201 Ascites Accumulation or retention of free fluid within the peritoneal cavity.

Related Publications

S Niikawa, and A Hara, and H Nokura, and T Uno, and A Ohkuma, and H Yamada
August 1976, Surgical neurology,
S Niikawa, and A Hara, and H Nokura, and T Uno, and A Ohkuma, and H Yamada
October 1993, Surgical neurology,
S Niikawa, and A Hara, and H Nokura, and T Uno, and A Ohkuma, and H Yamada
July 2021, The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques,
S Niikawa, and A Hara, and H Nokura, and T Uno, and A Ohkuma, and H Yamada
June 1956, Arquivos de neuro-psiquiatria,
S Niikawa, and A Hara, and H Nokura, and T Uno, and A Ohkuma, and H Yamada
June 2020, The Cochrane database of systematic reviews,
S Niikawa, and A Hara, and H Nokura, and T Uno, and A Ohkuma, and H Yamada
June 2008, Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery,
S Niikawa, and A Hara, and H Nokura, and T Uno, and A Ohkuma, and H Yamada
June 1956, Annals of internal medicine,
S Niikawa, and A Hara, and H Nokura, and T Uno, and A Ohkuma, and H Yamada
November 1953, Military surgeon,
S Niikawa, and A Hara, and H Nokura, and T Uno, and A Ohkuma, and H Yamada
December 1985, Neurologia medico-chirurgica,
S Niikawa, and A Hara, and H Nokura, and T Uno, and A Ohkuma, and H Yamada
March 1952, The Indian journal of surgery,
Copied contents to your clipboard!