Cryptococcal meningitis with severe visual and hearing loss and radiculopathy in a patient without immunodeficiency.
Cryptococcosis is an important cause of lymphocytic meningitis, especially but not necessarily in immunocompromised patients. We present the case of a 23-year-old man with a severe and rapid course of a cryptococcal meningoencephalitis, which led to visual and hearing loss, psychotic illness and radiculopathy. There was no evidence of immunodeficiency. Treatment with amphotericin B and flucytosine led to improvement of the symptoms but did not eradicate the micro-organisms from the cerebrospinal fluid (CSF). Maintenance therapy with fluconazole was necessary and led to improvement of the CSF pathology.
Schepelmann
K
K
Department of Neurology, University of Tübingen, Germany.
Müller
F
F
Dichgans
J
J
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D015725:Fluconazole / Q000627:therapeutic use; D005437:Flucytosine / Q000627:therapeutic use; D006312:Hearing Loss, Bilateral / Q000209:etiology*; D006801:Humans; D008297:Male; D016919:Meningitis, Cryptococcal / Q000134:cerebrospinal fluid / Q000150:complications* / Q000188:drug therapy; D011128:Polyradiculopathy / Q000209:etiology*; D014786:Vision Disorders / Q000209:etiology*
D000666:Amphotericin B; D015725:Fluconazole; D005437:Flucytosine