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Cryptococcal Meningitis in A Patient With Giant Cell Arteritis

Jin Lv1, Qiankun Zhang2

  • 1Department of Neurology, Lishui People's Hospital, Lishui, China.

Archives of Rheumatology
|June 15, 2018
PubMed

Insights

Cryptococcal meningitis can mimic giant cell vasculitis relapse, delaying diagnosis. This case highlights cryptococcal meningitis occurring during high-dose steroid treatment for giant cell vasculitis.

Area of Science:

  • Infectious Diseases
  • Rheumatology
  • Neurology

Background:

  • Giant cell vasculitis (GCV) is a systemic vasculitis primarily affecting large arteries.
  • High-dose corticosteroid therapy is the mainstay treatment for GCV.
  • Opportunistic infections, such as fungal meningitis, are potential complications of immunosuppressive therapy.

Observation:

  • A 65-year-old female patient with a history of GCV presented with symptoms mimicking a relapse.
  • The patient was undergoing high-dose steroid therapy for GCV at the time of presentation.
  • Clinical manifestations were initially attributed to GCV relapse.

Findings:

  • The patient was diagnosed with cryptococcal meningitis, a rare complication.
  • The symptoms of cryptococcal meningitis closely resembled those of GCV relapse.
  • Delayed diagnosis occurred due to the overlapping clinical presentation.

Implications:

  • This case underscores the importance of considering opportunistic infections in patients with GCV on immunosuppressive therapy.
  • Enhanced diagnostic vigilance is crucial to differentiate cryptococcal meningitis from GCV relapse.
  • Early recognition and treatment of cryptococcal meningitis are vital to prevent severe neurological sequelae.
Keywords:
Cryptococcal meningitisgiant cell vasculitisglucocorticoids

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