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Automated Measurement of Cryptococcal Species Polysaccharide Capsule and Cell Body
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Automated Measurement of Cryptococcal Species Polysaccharide Capsule and Cell Body

Published on: January 11, 2018

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Cryptococcal meningitis presenting as acute flaccid paralysis: A case report

Vanessa Correa-Forero1, Gabriel D Pinilla-Monsalve2, Jaime A Valderrama-Chaparro3

  • 1Fundación Valle del Lili, Department of Internal Medicine, Cra. 98 No. 18-49, Cali, Colombia; Facultad de Ciencias de la Salud, Universidad Icesi, Calle 18 No. 122-135, Cali, Colombia.

Journal of Infection and Public Health
|July 28, 2019
PubMed

Insights

Cryptococcal meningitis, a fungal infection, can cause rare cases of acute flaccid paralysis and peripheral nerve issues, even in non-HIV patients. Early diagnosis and antifungal treatment are crucial for recovery.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Mycology

Background:

  • Cryptococcus is a fungus known for nervous system infections, particularly in immunocompromised individuals.
  • Neurological cryptococcosis typically presents as meningitis with headache, fever, and neck stiffness, often affecting the brain.

Observation:

  • A rare case of a non-HIV, diabetic patient presenting with acute flaccid paralysis and peripheral nerve involvement is described.
  • The patient exhibited symptoms including dysarthria, facial paralysis, ascending quadriparesis, hyporeflexia, and urinary retention.
  • Initial neuroimaging was inconclusive for vascular or demyelinating causes, and electrophysiological studies suggested acute flaccid paralysis of unknown origin.

Findings:

  • Cerebrospinal fluid analysis confirmed Cryptococcus neoformans var. gatti as the causative agent.
  • The patient received antifungal treatment with amphotericin B and fluconazole.
  • Significant improvement in polyneuroradiculopathy symptoms was observed during hospitalization.

Implications:

  • This case highlights that spinal cord and peripheral nerve involvement by Cryptococcus can manifest as acute flaccid paralysis.
  • Cryptococcal meningitis should be considered in the differential diagnosis of acute flaccid paralysis, even in HIV-negative individuals.
  • Prompt diagnosis and appropriate antifungal therapy are essential for managing this rare neurological complication.
Keywords:
Acute flaccid paralysisCase reportCryptococcal meningitis

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