Cryptococcal meningitis mimicking cerebral infarction: a case report

Abstract

Weihua Zhou,1–3,* Jianbo Lai,1–3,* Tingting Huang,1 Yi Xu,1–3 Shaohua Hu1–3 1Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; 2The Key Laboratory of Mental Disorder’s Management in Zhejiang Province, Hangzhou 310003, China; 3Brain Research Institute of Zhejiang University, Hangzhou 310003, China *These authors contributed equally to this work Abstract: Cryptococcal meningitis (CM) is the most common type of fungal meningitis. The clinical symptoms of CM are nonspecific, and neuroimaging characteristics are variable. Herein, we present a case of a senile female with CM that was once misdiagnosed as cerebral infarction. Her condition worsened and she developed hydrocephalus. No apparent predisposing factors of CM were reported in this patient. The diagnosis of CM was definitely made after India ink staining of cerebrospinal fluid was positive. This case indicates that clinicians should bear cryptococcal infection in mind when the symptoms are nonspecific and neuroimaging findings are atypical. Keywords: cryptococcal meningitis, cerebral infarction, neuroimaging

Keywords

• cryptococcal meningitis
• cerebral infarction
• neuroimaging