Case Report: Cryptococcal Meningitis

Abstract

BACKGROUND: Cryptococcal meningitis is one of the most common opportunistic infections in immunocompromised patients. Mostly it manifests as subacute/chronic meningitis, although pathological findings suggest extensive tissue invasion of the brain parenchyma and meninges. This disease has a very high mortality rate, even with the administration of an antifungal combination. CASE REPORT: Male, 53 years old, with clinical symptoms of headache, was experienced by the patient from 1 month before admission and worsening within 1 week. The headache describe throbbing throughout the head, with severe intensity, and does not go away with pain medications. The frequency of headaches is persistent and does not go away with pain medications. A history of weight loss was found, about 10 kg in 3 months. A history of free sex was found. History of HIV known since 1 day before admission to hospital and has not undergone antiretroviral treatment. The patient was diagnosed with cryptococcal meningitis on the basis of the finding of yeas t-like cells on the Indian ink test, and the patient was also a stage IV HIV patient with a decreased CD4 count. The patients treated with tapering off dexamethasone injection, 1× 960 mg Cotrimoxazole, 400 mg/24 h injection of fluconazole, and 3 × 1 folic acid, and received 1 × 1 fixed dose combination antiretrovirals therapy. CONCLUSION: Cryptococcal meningitis is a disease caused by cryptococcal fungi and its incidence increases with the increase in diseases associated with immune system disorders such as HIV.