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Cryptococcal meningoencephalitis presenting transient focal cerebral symptoms

W J Nowack1, R W Bradsher

  • 1Department of Neurology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock 72205.

Southern Medical Journal
|March 1, 1989
PubMed

Insights

Cryptococcal meningoencephalitis, a fatal brain infection, can mimic transient ischemic attacks. Early cerebrospinal fluid analysis and antifungal treatment with amphotericin B and flucytosine offer a cure.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Medical Case Reports

Background:

  • Cryptococcal meningoencephalitis (CM) is a severe fungal infection of the brain and meninges.
  • Untreated CM has a high mortality rate.
  • CM can present with diverse neurological symptoms, sometimes mimicking other neurological conditions.

Observation:

  • An unusual case of CM was clinically diagnosed as transient ischemic attacks (TIAs).
  • The patient presented with transient focal cerebral dysfunction.
  • Cerebrospinal fluid analysis was crucial for diagnosis.

Findings:

  • Treatment with amphotericin B and flucytosine effectively cured the cryptococcal infection.
  • The patient experienced no further episodes of transient focal cerebral dysfunction after treatment.
  • This case highlights the importance of considering CM in patients with TIA-like symptoms.

Implications:

  • Cerebrospinal fluid examination should be considered in the diagnostic workup of patients presenting with transient focal cerebral symptoms.
  • Prompt diagnosis and appropriate antifungal therapy are critical for improving outcomes in CM.
  • This case underscores the varied clinical presentations of infectious central nervous system diseases.

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