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Cryptococcus meningitis presented with multiple cerebral infarcts in an immunocompetent patient
Buket Erturk Sengel1, Elif Tukenmez Tigen1, Rabia Can Sarinoglu2
1Marmara University, Faculty of Medicine, Infectious Disease and Clinical Microbiology, Istanbul, Turkey.
Insights
Cryptococcal meningitis, usually seen in immunocompromised individuals, can rarely affect immunocompetent patients. Early diagnosis using advanced panels like Biofire FilmArray is crucial for successful treatment and recovery.
Area of Science:
- Infectious Diseases
- Neurology
- Mycology
Background:
- Cryptococcus neoformans typically causes meningitis in individuals with weakened immune systems.
- However, infections can occur in immunocompetent individuals, often presenting with atypical or non-specific symptoms.
Observation:
- This report details a rare case of cryptococcal meningitis in an immunocompetent patient.
- The patient presented with multiple cerebral infarcts, a non-specific neurological manifestation.
Findings:
- Despite delayed diagnosis and the development of hydrocephalus during treatment, the patient achieved a full recovery without lasting neurological deficits.
- Conventional diagnostic tests for cryptococcosis may yield false negatives in immunocompetent hosts due to low fungal burdens.
Implications:
- The Biofire FilmArray meningitis panel offers high sensitivity and specificity for diagnosing cryptococcal meningitis, even in cases with low fungal loads.
- This case highlights the importance of considering cryptococcal meningitis in immunocompetent individuals presenting with neurological symptoms and underscores the utility of advanced diagnostic tools.
Abstract:
Cryptococcus neoformans is generally observed with immunosuppressive conditions. Rarely, it may be seen in immunocompetent individuals and presented with non-specific conditions. We described an immunocompetent case of cryptococcal meningitis presented with multiple cerebral infarcts. Despite the late diagnosis and emergence of hydrocephalus during treatment, the patient was recovered without any sequelae. In immunocompetent patients, the conventional diagnostics tests may be negative because of the low fungal load. If it is available, the Biofire FilmArray meningitis panel has high sensitivity and specificity for diagnosis.
