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[Cryptococcal meningitis associated with hydrocephalus in an immunocompetent patient]

Julián Castro Castro1, María Dolores Díaz López2

  • 1Complexo Hospitalario Universitario de Ourense. juliancastrocastro@yahoo.es.

Anales Del Sistema Sanitario De Navarra
|March 7, 2024
PubMed

Insights

Cryptococcal meningitis, though rare in immunocompetent individuals, can cause severe neurological issues like hydrocephalus. This case highlights successful endoscopic treatment and antifungal therapy for cryptococcal meningitis.

Area of Science:

  • Neurology
  • Infectious Diseases

Background:

  • Cryptococcal meningitis is a serious infection, typically seen in immunocompromised individuals.
  • Presentation in immunocompetent patients is uncommon, posing diagnostic challenges.

Observation:

  • A 67-year-old immunocompetent male presented with subacute gait disturbance and urinary incontinence.
  • Neurological examination revealed an inability to stand and memory impairment.
  • Cranial imaging identified obstructive tetraventricular hydrocephalus and cerebellar gliosis.

Findings:

  • Endoscopic treatment of hydrocephalus was performed.
  • Cerebrospinal fluid analysis confirmed Cryptococcus neoformans.
  • The patient showed improvement following endoscopic intervention and a ten-week course of liposomal amphotericin B and fluconazole.

Implications:

  • This case underscores the importance of considering Cryptococcal meningitis in immunocompetent patients with neurological deficits.
  • Hydrocephalus as a presentation necessitates surgical management, including endoscopic techniques.
  • Combined endoscopic treatment and antifungal therapy can be effective for cryptococcal meningitis in immunocompetent hosts.

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