Related Experiment Videos
Abstract:
A patient was admitted to hospital with an apparent psychiatric disturbance. When she became stuporous the cerebrospinal fluid was cultured but proved sterile. The latex test showed that serum was positive for cryptococcal antigens, and cryptococcal meningoencephalitis was diagnosed. Amphotericin B was given but when she developed a toxic reaction it was replaced by flucytosine. She responded well to flucytosine alone and no side effects appeared on continued treatment. Cryptococcal meningitis may present as a psychiatric disturbance, and serological tests are invaluable aids to diagnosis.
Insights
Cryptococcal meningitis can mimic psychiatric disorders. Prompt diagnosis using latex agglutination tests and treatment with flucytosine is crucial for patient recovery.
Area of Science:
- Neurology
- Infectious Diseases
- Mycology
Background:
- Cryptococcal meningitis is a serious fungal infection affecting the central nervous system.
- It can present with atypical symptoms, including psychiatric disturbances, complicating early diagnosis.
Purpose of the Study:
- To highlight the diagnostic challenges of cryptococcal meningitis presenting as psychiatric disturbance.
- To emphasize the utility of serological tests in diagnosing this condition.
- To report on the treatment outcomes of cryptococcal meningoencephalitis.
Main Methods:
- Case report of a patient admitted with psychiatric disturbance.
- Cerebrospinal fluid (CSF) culture and latex agglutination testing for cryptococcal antigens.
- Treatment with antifungal agents, including amphotericin B and flucytosine.
Main Results:
- CSF culture was sterile, but serum latex test was positive for cryptococcal antigens.
- Diagnosis of cryptococcal meningoencephalitis was confirmed.
- Patient responded well to flucytosine after initial treatment with amphotericin B caused toxicity.
Conclusions:
- Cryptococcal meningitis can manifest initially as a psychiatric disturbance.
- Serological tests, such as the latex agglutination test, are vital for accurate and timely diagnosis.
- Flucytosine is an effective treatment option for cryptococcal meningoencephalitis, particularly when amphotericin B is not tolerated.