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.