[Central nervous system vasculitis in immunocompetent patients with cryptococcal meningitis]

Area of Science:

• Neurology
• Infectious Diseases
• Mycology

Background:

• Meningeal cryptococcosis (MC) is a rare but serious fungal infection.
• Diagnosis in immunocompetent patients is challenging due to infrequent occurrence and varied symptoms.
• Central nervous system (CNS) vasculitis with cerebral infarctions is a potential neurological complication of MC.

Purpose of the Study:

• To present two cases of meningeal cryptococcosis in immunocompetent patients with CNS vasculitis.
• To describe the clinical course, treatment, and outcomes.
• To emphasize the importance of considering MC in differential diagnoses and the role of corticosteroids.

Main Methods:

• Retrospective, observational case series.
• Review of medical records for two immunocompetent patients diagnosed with MC and CNS vasculitis.
• Analysis of treatment regimens and clinical evolution.

Main Results:

• Both patients were immunocompetent and developed CNS vasculitis secondary to MC.
• One patient required prolonged steroid and antifungal therapy due to recurrent symptoms and lesions.
• The second patient improved with initial steroid and antifungal treatment.

Conclusions:

• Meningeal cryptococcosis should be considered in the differential diagnosis of CNS vasculitis in immunocompetent patients.
• Corticosteroid therapy may be beneficial in managing CNS vasculitis associated with MC.
• Prompt diagnosis and appropriate management are crucial for favorable outcomes.