Cryptococcal Meningoencephalitis in HIV/AIDS Patient Coinfected with Tuberculosis. Case Report

Abstract

Cryptococcal meningitis is an inflammation of the meninges due to Cryptococcus fungal infection which commonly invades people living with immunodeficiency virus (PLHIV) with impaired immunity. The disease has a high mortality rate and is frequently misdiagnosed in the early stages due to vague symptoms. This case report aimed to provide information regarding the diagnosis and management of cryptococcal meningoencephalitis in patients with acquired immunodeficiency syndrome (AIDS) and tuberculosis. We reported a case of a 34-year-old woman that complained of headache and fever for the last month. There were also oral white patches in the last two weeks. The patient was diagnosed with lung tuberculosis (TB) and human immunodeficiency virus (HIV) in February 2021, but the TB was just being treated in the last two months, and HIV in the last two weeks. Head CT scan with contrast showed meningoencephalitis, brain edema, left frontal, left ethmoidal, left and right maxillary, and left sphenoid sinusitis. On the 9th day of hospitalization, the patient hadseizures. Analysisofthecerebrospinalfluidculture revealed Cryptococcus neoformans. The patient's comorbidities were leucopenia, hypoalbuminemia, pneumonia, and brain edema which led to a poor prognosis. On the 10th day, the seizures relapsed, followed by drastically reduced SpO2 and death. Septic shock and multiorgan failure were considered the cause of death in the case. This case highlights the importance of early diagnosis and management to avoid unfavorable outcomes.