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Clinics and Practice
Volume 7
Issue 4
10.4081/cp.2017.1002
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Clinics and Practice is published by MDPI from Volume 11 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with PAGEPress.
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Case Report

A Rare Presentation of Cryptococcal Meningoencephalitis in an Immunocompetent Individual

by
Ashwin Malhotra
1,2,*,
Qin Rao
2,
Sean Kelly
3,
Danielle Schwartz
2 and
Robert Chow
4
1
Department of Neurology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA
2
Department of Medicine, Stony Brook University Hospital, New York, NY, USA
3
Stony Brook University School of Medicine, Stony Brook University, New York, NY, USA
4
Department of Infectious Disease, Stony Brook University Hospital, New York, NY, USA
*
Author to whom correspondence should be addressed.
Clin. Pract. 2017, 7(4), 1002; https://doi.org/10.4081/cp.2017.1002
Submission received: 8 July 2017 / Revised: 8 July 2017 / Accepted: 21 August 2017 / Published: 15 September 2017

Abstract

Cryptococcal meningoencephalitis is a leading of morbidity and mortality in immunocompromised individuals worldwide. However, there are few documented cases in immunocompetent patients. We present a rare case of disseminated Cryptococcus with progression to meningoencephalitis in an immunocompetent patient, with a possible atypical presentation. Magnetic resonance imaging of the brain and electroencephalogram to rule out brain metastasis were negative. Lumbar puncture resulted positive for Cryptococcus neoformans antigen at titers of 1:2048 and a detailed history later revealed occupational exposure to bird dander by cleaning floors and cages. Diagnosis is challenging, with delays often resulting in increased morbidity and mortality. Cerebrospinal fluid and serum Cryptococcus antigen play a key role in both diagnosis and determining treatment efficacy. Furthermore, current treatment guidelines are used for immunocompromised individuals. Due to the significant side effects of these medications, further research is needed to determine the optimal treatment duration for immunocompetent patients to minimize the need for unnecessary therapy.
Keywords: altered mental status; cryptococcal meningoencephalitis; lumbar puncture altered mental status; cryptococcal meningoencephalitis; lumbar puncture

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MDPI and ACS Style

Malhotra, A.; Rao, Q.; Kelly, S.; Schwartz, D.; Chow, R. A Rare Presentation of Cryptococcal Meningoencephalitis in an Immunocompetent Individual. Clin. Pract. 2017, 7, 1002. https://doi.org/10.4081/cp.2017.1002

AMA Style

Malhotra A, Rao Q, Kelly S, Schwartz D, Chow R. A Rare Presentation of Cryptococcal Meningoencephalitis in an Immunocompetent Individual. Clinics and Practice. 2017; 7(4):1002. https://doi.org/10.4081/cp.2017.1002

Chicago/Turabian Style

Malhotra, Ashwin, Qin Rao, Sean Kelly, Danielle Schwartz, and Robert Chow. 2017. "A Rare Presentation of Cryptococcal Meningoencephalitis in an Immunocompetent Individual" Clinics and Practice 7, no. 4: 1002. https://doi.org/10.4081/cp.2017.1002

APA Style

Malhotra, A., Rao, Q., Kelly, S., Schwartz, D., & Chow, R. (2017). A Rare Presentation of Cryptococcal Meningoencephalitis in an Immunocompetent Individual. Clinics and Practice, 7(4), 1002. https://doi.org/10.4081/cp.2017.1002

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