Abstract
58-year-old man presented with headache, nausea, vomiting, and gait disturbance. Brain MRI showed meningeal enhancement and herniation. Serum Cryptococcus antigen was positive but spinal fluid antigen and cultures were negative. A cerebellar biopsy revealed nonencapsulated Cryptococcus. He completed antifungal therapy. Serum Cryptococcus antigen titer decreased. He had a full neurological recovery.
Highlights
58-year-old man presented with headache, nausea, vomiting, and gait disturbance
A serum Cryptococcus antigen screen was ordered in the emergency department due to the significant hydrocephalus and the recent diagnosis of meningitis
We presented a case of a patient with granulomatous meningitis due to Cryptococcus with negative fungal cultures, negative Cryptococcus antigen in the CSF, and no evidence of capsule on histopathology but a positive serum Cryptococcus antigen
Summary
58-year-old man presented with headache, nausea, vomiting, and gait disturbance. Brain MRI showed meningeal enhancement and herniation. Serum Cryptococcus antigen was positive but spinal fluid antigen and cultures were negative. A 58-year-old man with history of hypertension presented with a headache that started two months prior to admission.
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