Neuropsychic Disorders Unmasking the Coexistence of Fahr Syndrome and Neuromeningeal Cryptococcosis

Abstract

Background: Fahr syndrome associates a set of neuropsychiatric manifestations with bilateral calcifications in the basal ganglia and phosphocalcic disorders. Neuromeningeal cryptococcosis can be present in its manifestations, neuropsychic disorders with or without meningeal signs. The objective was to describe a rare association between Fahr syndrome and neuromeningeal cryptococcosis which can be expressed by the same clinical symptomatology in the context of co-infection with the human immunodeficiency virus (HIV) and the hepatitis B virus (HBV). Presentation: A 37-year-old patient without pathological history, who presented behavioral disorders that led to a fight with those around her and a psychiatric consultation. Then, she was hospitalized in the infectious diseases Department upon discovery of her HIV status and viral hepatitis B. She was logorrheic with behavioral disturbances and subsequently presented with tonic-clonic convulsions. Laboratory tests and imaging have concomitantly discovered Fahr syndrome due to pseudohypoparathyroidism and neuromeningeal cryptococcosis. The correct management of these two pathologies enabled stabilization of the patient's clinical condition with regular monitoring for HIV-HBV coinfection. Conclusion: Farh syndrome and neuromeningeal cryptococcosis are two different entities but sometimes similar symptoms and risk factors. Treatment of metabolic disorders combined with anticryptococcal therapy improved the prognosis.