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Fluorescence in a cryptococcoma following administration of 5-aminolevulinic acid hydrochloride (Gliolan)
  1. Waldo Gerard Solis,
  2. Mitchell Hansen
  1. Department of Neurosurgery, John Hunter Hospital, New Lambton, New South Wales, Australia
  1. Correspondence to Dr Waldo Gerard Solis, waldo.g.solis{at}


A 54-year-old man presented with two episodes of dysarthria and left facial droop. Both episodes resolved by the time of examination. MRI of the brain revealed a right frontotemporal, heterogeneously enhancing mass with surrounding vasogenic oedema, suggestive of a high-grade primary brain neoplasm. The patient was administered preoperative 5-aminolevulinic acid hydrochloride (Gliolan), and fluorescence-guided resection of the lesion was undertaken. Cryptococcus gattii infection was diagnosed from the specimen and the patient was given appropriate antifungal treatment. This is the first reported case of Gliolan-mediated fluorescence in a fungal abscess and highlights one of the potential pitfalls in fluorescence-guided surgery.

  • Neurosurgery
  • Infectious diseases
  • Drug therapy related to surgery
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  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review WGS wrote and analysed the study and prepared the literature search. MH analysed, edited and finalised the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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