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Cryptococcal meningitis presenting with bilateral complete ophthalmoplegia: a case report
Damith S Liyanage1, Lakmini P S Pathberiya, Inuka K Gooneratne
1Institute of Neurology, National Hospital of Sri Lanka, Colombo, Sri Lanka. damithsl@gmail.com.
BMC Research Notes
|June 3, 2014
Summary
Cryptococcal meningitis is a rare but serious fungal infection in kidney transplant recipients. This case highlights bilateral complete ophthalmoplegia as a rare complication, emphasizing prompt diagnosis in immunocompromised individuals.
Area of Science:
- Mycology
- Infectious Diseases
- Neuro-ophthalmology
Background:
- Cryptococcus neoformans is an encapsulated yeast causing opportunistic infections.
- Cryptococcal meningitis is a severe complication in transplant recipients.
- Ophthalmoplegia is a known complication, but bilateral complete form is exceptionally rare.
Observation:
- A post-kidney transplant patient presented with bilateral complete ophthalmoplegia.
- Cerebrospinal fluid analysis confirmed cryptococcal meningitis.
- MRI revealed bilateral thalamic and basal ganglia lesions.
Findings:
- The patient was diagnosed with cryptococcal meningitis.
- Bilateral complete ophthalmoplegia was the presenting neurological deficit.
- Thalamic lesions and cranial nerve involvement were implicated.
Implications:
- Cryptococcal meningitis requires high suspicion in immunocompromised patients with neurological deficits.
- Early diagnosis and treatment are crucial for managing this severe fungal infection.
- Understanding rare presentations like bilateral ophthalmoplegia aids in clinical management.
