Non-acquired immunodeficiency syndrome-related cryptococcal meningitis with recurrent acute stroke: A case report.

Abstract

Cryptococcal meningitis has been reported to be primarily associated with human immunodeficiency virus infection. Herein, we report the case of a male patient in China with recurrent acute stroke as the first clinical manifestation, followed by several symptoms of intracranial infection, such as headache, a stiff neck, disturbance of consciousness, and high fever. The patient tested negative for human immunodeficiency virus and was diagnosed with cryptococcal meningitis after lung computed tomography, cranial computed tomography, cranial magnetic resonance imaging, and cerebrospinal fluid examination. The combination of conventional amphotericin B and flucytosine tablets progressively worsened the patient's condition. This was accompanied by a series of complications, such as respiratory failure, hepatic and renal insufficiency, and infectious shock, leading to the patient's death. To date, only a few cases of non-acquired immunodeficiency syndrome-related cryptococcal meningitis with recurrent acute stroke have been reported. This case report suggests that clinicians should be alert to the possibility of cryptococcal meningitis in patients with imaging manifestations of meningitis and promptly perform cryptococcal capsular antigen testing, a highly sensitive screening method. Therefore, this case study could lead to new insights into the clinical diagnosis and treatment of non-acquired immunodeficiency syndrome-related cryptococcal meningitis with recurrent acute stroke.