An unusual case of stroke.
New imaging techniques have allowed for the rapid and accurate diagnosis of stroke. In this case, we present a 58-year-old woman with multiple large vessel strokes on magnetic resonance imaging. The initial diagnostic workup centered on a rapidly progressive central nervous system vasculitis. Subsequent workup revealed an unusual infectious etiology--cryptococcal meningitis. Although fungal infections can cause vasculitis, this is the first report of a patient with multiple anterior and posterior circulation strokes secondary to Cryptococcus. The diagnosis in cases presenting with encepalopathy and without fever is often delayed.
Department of Neurology, University of Connecticut Health Center, The Stroke Center, Hartford, CT 06030, USA.
Michael
M
Rosario
Sarah Xianyuan
SX
Song
Louise D
LD
McCullough
D000959:Antihypertensive Agents / Q000008:administration & dosage; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003937:Diagnosis, Differential; D004232:Diuretics / Q000008:administration & dosage; D005260:Female; D005665:Furosemide / Q000008:administration & dosage; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications; D007037:Hypothyroidism / Q000150:complications; D007328:Insulin / Q000008:administration & dosage; D017706:Lisinopril / Q000008:administration & dosage; D008103:Liver Cirrhosis / Q000150:complications; D017116:Low Back Pain / Q000150:complications; D008279:Magnetic Resonance Imaging; D016919:Meningitis, Cryptococcal / Q000150:complications* / Q000175:diagnosis*; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010003:Osteoarthritis / Q000150:complications; D011241:Prednisone / Q000008:administration & dosage; D020521:Stroke / Q000209:etiology*; D013974:Thyroxine / Q000008:administration & dosage; D020293:Vasculitis, Central Nervous System / Q000175:diagnosis
D000959:Antihypertensive Agents; D004232:Diuretics; D007328:Insulin; D005665:Furosemide; D017706:Lisinopril; D013974:Thyroxine; D011241:Prednisone