UNUSUAL PATTERN OF ENHANCEMENT IN CRYPTOCOCCAL MENINGITIS - IN-VIVO FINDINGS WITH POSTMORTEM CORRELATION

Leptomeningeal enhancement on CT and MR imaging studies secondary to c ryptococcal meningitis is an uncommon finding. In immunocompromised pa tients, this meningitis incites only a mild inflammatory reaction and abnormalities are often absent on imaging studies. We recently encount ered two patients with cryptococcal meningitis in whom postcontrast MR imaging showed thick enhancing subarachnoid spaces. Both had cryptoco ccal meningitis at autopsy. In a different patient with cryptococcal m eningitis, post-mortem MR imaging and pathologic examinations showed t hat these areas of enhancement correspond to abundant mucoid material secreted by the yeasts.