Cryptococcal meningitis in an immunocompetent patient-missed diagnosis-a case report

Abstract

Cryptococcosis is an important opportunistic fungal infection worldwide, but in many countries, including India, many cases are seen among immunocompetent individuals. Cryptococcal meningitis is a severe and fatal infection if not diagnosed and treated specifically in time. Its diagnosis is challenging because its signs and symptoms are indistinguishable from other sub-acute and chronic CNS infections. If it is not suspected and the tests for fungal etiology are not performed for all the cases of meningitis, the diagnosis of Cryptococcal meningitis may be missed. Here we present a case of Cryptococcal meningitis in which the CSF was not tested for fungal etiology and the patient was wrongly treated for Tubercular meningitis. This case highlights the importance of performing the tests for fungal etiology in all cases of meningitis.

Cryptococcal meningitis with suspected concomitant neurosyphilis in an immunocompetent individual: A diagnostic dilemma

“…Visual impairment, cranial nerve palsies and strokes are known complications. CSF analysis typically shows lymphocytic pleocytosis with high protein and low glucose levels (1). Diagnosis of CM can be made by the rapid cryptococcal antigen assay and CSF India ink staining test.…”

“…Cryptococcal meningitis (CM) and neurosyphilis occur in regions with a high prevalence of human immunodeficiency virus (HIV) infection [1,2]. Occurrence in immunocompetent individuals is rare.…”