BACKGROUND Transverse myelitis (TM) is due to inflammatory spinal cord injury with bilateral neurologic involvement, which is sensory, motor, or autonomic in nature. It may be associated with autoimmune disease, vaccination, intoxication and infections. The most common infection cause of TM is Coxsackie virus and Mycoplasma pneumoniae. The cryptococcosis is rare. We present the case of disseminated cryptococcosis revealed by transverse myelitis in an immunocompetent 55-year-old male patient. The literature review is also stated. CASE PRESENTATION The 55-year-old man suffered from gradual numbness, weakness in both lower limbs and finally paralyzed in the bed. The thoracic spine Computed tomography (CT) was normal, but multiple nodules in the lung were accidentally discovered. Thoracic Magnetic Resonance Imaging (MRI) showed diffused thoracic spinal cord thickening and extensively intramedullary T2 hyper intensity areas. Gadolinium contrast enhanced T1WI showed an intramedullary circle-enhanced nodule at 9th thoracic level. Diagnosis was made by histological examination of the bilateral lung biopsy. The patient was treated successfully with systemic amphotericin B liposome and fluconazole and intrathecal dexamethasone and amphotericin B liposome. CONCLUSIONS This is a patient with disseminated cryptococcosis involving the lung, spinal cord and adrenal glands, which is rare in the absence of immunodeficiency.

中文翻译：

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免疫功能正常的患者横贯性脊髓炎可发现隐性隐球菌病：一例病例报告并文献复习。

背景技术横贯性脊髓炎（TM）是由于炎症性脊髓损伤和双侧神经系统受累所致，本质上是感觉，运动或自主神经。它可能与自身免疫性疾病，疫苗接种，中毒和感染有关。TM的最常见感染原因是柯萨奇病毒和肺炎支原体。隐球菌病很少见。我们介绍了一例具有免疫功能的55岁男性患者中的横向脊髓炎所揭示的弥漫性隐球菌病。还陈述了文献综述。病例介绍一名55岁的男子患有逐渐麻木，下肢无力，最后瘫痪在床上。胸椎计算机断层扫描（CT）正常，但意外发现肺部有多个结节。胸腔磁共振成像（MRI）显示胸椎脊髓弥漫性增厚和髓内T2高强度区域。contrast对比度增强的T1WI显示在第9胸廓处髓内圆增强结节。通过双侧肺活检的组织学检查进行诊断。用全身性两性霉素B脂质体和氟康唑以及鞘内地塞米松和两性霉素B脂质体成功治疗了该患者。结论该患者为散发性隐球菌病，累及肺，脊髓和肾上腺，在缺乏免疫缺陷的情况下很少见。通过双侧肺活检的组织学检查进行诊断。用全身性两性霉素B脂质体和氟康唑以及鞘内地塞米松和两性霉素B脂质体成功治疗了该患者。结论该患者为散发性隐球菌病，累及肺，脊髓和肾上腺，在缺乏免疫缺陷的情况下很少见。通过双侧肺活检的组织学检查进行诊断。用全身性两性霉素B脂质体和氟康唑以及鞘内地塞米松和两性霉素B脂质体成功治疗了该患者。结论该患者为散发性隐球菌病，累及肺，脊髓和肾上腺，在缺乏免疫缺陷的情况下很少见。