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Cryptococcal Meningitis Developing in a Patient with Neurosarcoidosis
Shinnosuke Fukushima1, Hideharu Hagiya1, Yukichika Yamamoto1
1Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
Abstract:
Cryptococcal meningitis is a critical disease that occasionally involves immunosuppressed patients. We herein report a 79-year-old Japanese man who received low-dose prednisolone therapy for neurosarcoidosis and panhypopituitarism. He presented a 10-day history of a fever and altered mental status. The FilmArray® Meningitis/Encephalitis Panel and serum cryptococcal antigen tests were both negative, but the cerebrospinal fluid sample became positive for Cryptococcus neoformans after seven-day incubation. After the diagnosis of cryptococcal meningitis, we successfully treated the patient with a recommended treatment regimen. When an immunocompromised patient presents with a subacute fever accompanying any central nervous symptoms, cryptococcal meningitis should be screened for.
Insights
Cryptococcal meningitis can affect immunocompromised patients. Early screening is crucial, even with negative initial tests, for timely diagnosis and treatment of this critical central nervous system infection.
Area of Science:
- Infectious Diseases
- Neurology
- Immunology
Background:
- Cryptococcal meningitis is a serious infection, particularly in immunocompromised individuals.
- Low-dose prednisolone therapy for conditions like neurosarcoidosis can increase susceptibility.
- Subacute fever and altered mental status are key presenting symptoms.
