Cryptococcal Meningitis in Immunocompetent Patient-Case Report

Abstract

Cryptococcal Meningitis (CM) is a rare infection in immunocompetent patients. A kind of central nervous system infection caused by encapsulated yeast-like fungus Cryptococcus neoformans. A 59-year-old man presented to the Neurology Department of Nova Iguacu General Hospital, complaining has felt "muddled" recently and feeling diaphragmatic spasm without any apparent cause. In addition, at neurological examination, the patient was slightly confused and during the mini-mental state examination he scored less than 20 points, feeling "slowed down", no cranial nerve dysfunction, "rigidity of gait as well as of hand movements, more pronounced on the right one, pyramidal signs bilaterally were more intensely noted on the left". His MRI, lumbar puncture, fungal isolation and Nakin Ink were positive to Cryptococcosis while, in turn, HIV tests I and II were both negative. The treatment was started with Amphotericin B 50 mg IV, once a day, plus Dexamethashone. From our clinical case, we decided to do a brief review about Cryptococcoal Meningitis in immunocompetents and Cryptococcoma, researching at MedLine and Pubmed, using terms "Cryptococcal meningitis", "Cryptococcal meningitis in immunocompetent" and "Cryptococcomas". It is concluded that CM in immunocompetents is uncommon, but an important cause of non-acute meningitis, that should be included in the range of causes of preventable blindness. In this sense, this article purposes advertise clinicians and specialists, to recognize the clinical manifestation and diagnosis of cryptococcal meningitis in immunocompetents, trying to avoid a later diagnosis and the following complications.