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Secondary mania due to AIDS and cryptococcal meningitis in a 78-year-old patient

Po-Han Chou1, Wen-Chen Ouyang2,3,4,5, Tsuo-Hung Lan1

  • 1Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan.

Psychogeriatrics : the Official Journal of the Japanese Psychogeriatric Society
|April 29, 2015
PubMed

Insights

A first-time manic episode in an elderly man was treated, but he was later diagnosed with AIDS and Cryptococcus neoformans meningitis. This case underscores the need to exclude secondary causes for new psychiatric symptoms in older adults.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Psychiatry

Background:

  • First-episode mania in elderly patients requires thorough investigation.
  • Differential diagnoses for psychiatric symptoms in older adults must include organic causes.

Observation:

  • A 78-year-old male presented with a first-time manic episode.
  • Initial treatment with quetiapine and lorazepam was successful for manic symptoms.

Findings:

  • The patient was diagnosed with Acquired Immunodeficiency Syndrome (AIDS).
  • Cerebrospinal fluid analysis revealed Cryptococcus neoformans meningitis.

Implications:

  • Highlights the critical importance of comprehensive differential diagnoses in geriatric psychiatry.
  • Underscores the need to rule out secondary causes, such as infections, for new-onset psychiatric manifestations in the elderly.
  • Emphasizes the link between opportunistic infections in AIDS and neurological/psychiatric presentations.
Keywords:
Cryptococcus neoformans meningitis (CNM)acquired immunodeficiency syndrome (AIDS)secondary mania

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