Cryptococcal meningitis presenting as sixth nerve palsy

Abstract

Clinical features of cryptococcal meningitis can often be non-specific in immunocompetent without neurological deficit. We present a case of a middle-aged female with no known co-morbidities who presented with sub-acute onset of occipital headache, vomiting and isolated 6th nerve palsy, photophobia and double vision of 2 weeks. It progressed with development of multiple nerve palsies, bilateral lower limb paresis and complete loss of vision. She had no evidence of immunosuppression.