Abstract
The clinical presentations of cryptococcal meningitis in HIV-negative patients may be different from that infected with HIV. We report a case of 75-year old male with chronic lymphoid leukemia presenting with recurrent syncope, bi-frontal headache and diplopia. This case discusses the atypical presentations of cryptococcal meningitis in HIV-negative patients and its importance of early diagnosis.
Highlights
We have presented the first reported case of cryptococcal meningitis in a patient with chronic lymphoid leukemia (CLL) presenting with recurrent syncope
It is often difficult to reach a definitive diagnosis of cryptococcal meningitis in HIV-negative patients
Lumbar puncture, being an invasive procedure is not routinely performed in patients who presented with atypical signs and symptoms of meningitis
Summary
Among non-HIV patients with cryptococcal meningitis, most patients present with signs and symptoms of meningitis and fever is seen only in 50% of cases [1]. 75 year old retired Caucasian male presented to the emergency room with an episode of syncope He was complaining of mild bi-frontal headache. A CT scan of the head showed acute sinusitis of bilateral maxillary sinus He was diagnosed with acute sinusitis and discharged with oral levofloxacin. One week later, he again presented to the emergency room with another episode of syncope for few seconds. No clear etiology of syncope was found and he was discharged home in a stable condition He again presented to the emergency room three days later with double vision of right eye, worsening bi-frontal headache and an episode of syncope. At the time of the case report was written, the patient was being treated with oral fluconazole (consolidation therapy) and being discharged to a rehabilitation facility
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