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Cryptococcal Meningitis Presenting as New-Onset Seizures in an Immunocompetent Patient

Andrea Akyeampong1, Nadia Solomon1, Nicholas A Boire1

  • 11 St. George's University, True Blue, Grenada.

Journal of Investigative Medicine High Impact Case Reports
|July 30, 2019
PubMed

Insights

A rare case of Cryptococcus infection presented as brain lesions causing seizures in an immunocompetent male. Diagnostic challenges highlight the importance of persistent investigation for unusual infectious causes.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Medical Mycology

Background:

  • Central nervous system (CNS) infections can present with diverse neurological symptoms.
  • Immunocompetent individuals are typically less susceptible to opportunistic fungal infections like Cryptococcus.

Observation:

  • A 30-year-old immunocompetent male presented with new-onset seizures and two enhancing brain lesions on imaging.
  • Surgical resection revealed necrotic and cystic brain tissue, but initial extensive laboratory testing for common pathogens was negative.

Findings:

  • Despite negative cerebrospinal fluid (CSF) cultures and antigen tests, persistent investigation ultimately identified Cryptococcus as the causative agent via CSF antigen testing.
  • The patient's presentation was atypical, challenging initial diagnostic assumptions.

Implications:

  • This case underscores the importance of considering unusual infectious etiologies in patients with unexplained neurological symptoms and brain lesions.
  • Diagnostic strategies for CNS infections may need to be broadened to include less common pathogens, even in immunocompetent hosts.
  • Atypical presentations necessitate thorough and prolonged diagnostic workups to ensure accurate identification of causative agents.
Keywords:
cryptococcosisdiagnostic delayinfectious diseasepathologyseizure

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