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Middle cerebral artery territory infarct due to Cryptococcus infectionstitle: an uncommon indication for
David Cachia1, Charanjeet Singh2, Michael T Tetzlaff3
1Department of Neuro-Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
Abstract:
Cryptococcal meningitis is the most common manifestation of cryptococcosis and is caused by the encapsulated yeast organism Cryptococcus neoformans. It occurs most commonly in patients with impaired cell-mediated immunity such as in HIV infection; patients with hematological malignancies; patients post solid-organ transplantation; on chronic steroids or immunosuppressants. Clinically, stroke can arise as a complication of cryptococcal meningitis. While cerebrospinal fluid (CSF) examination is usually not indicated for evaluation of stroke patients, demonstration of cryptococcal yeast forms in CSF is valuable in guiding appropriate therapy in arterial stroke caused by Cryptococci. Herein, we describe the CSF and radiologic correlation in a female patient who presented with disseminated cryptococcosis, cryptococcal meninigitis and a middle cerebral artery infarct.
Insights
Cryptococcal meningitis, a serious infection, can lead to stroke, particularly in immunocompromised individuals. Identifying Cryptococcus in cerebrospinal fluid aids in treating strokes caused by this yeast.
Area of Science:
- Infectious Diseases
- Neurology
- Medical Mycology
Background:
- Cryptococcal meningitis is a severe manifestation of Cryptococcus neoformans infection, primarily affecting immunocompromised patients.
- Patients at risk include those with HIV, hematological malignancies, organ transplants, or on immunosuppressive therapy.
- Stroke is a recognized complication of cryptococcal meningitis.
Observation:
- This case report details a female patient with disseminated cryptococcosis and cryptococcal meningitis.
- The patient presented with a middle cerebral artery infarct.
Findings:
- Cerebrospinal fluid (CSF) analysis revealed the presence of Cryptococcus yeast forms.
- Radiological findings correlated with the CSF examination.
- Demonstration of yeast in CSF is crucial for guiding therapy in cryptococcal-induced arterial stroke.
Implications:
- Highlights the importance of CSF analysis in stroke patients with suspected cryptococcosis.
- Emphasizes the link between cryptococcal meningitis and cerebrovascular events.
- Informs clinical management strategies for cryptococcal infections and associated neurological complications.
