title: Middle cerebral artery territory infarct due to Cryptococcus infectionstitle: an uncommon indication for cerebrospinal fluid analysis in stroke patients.
abstract: Cryptococcal meningitis is the most common manifestation of cryptococcosis and is caused by the encapsulated yeast organism Cryptococcus neoformans. It occurs most commonly in patients with impaired cell-mediated immunity such as in HIV infection; patients with hematological malignancies; patients post solid-organ transplantation; on chronic steroids or immunosuppressants. Clinically, stroke can arise as a complication of cryptococcal meningitis. While cerebrospinal fluid (CSF) examination is usually not indicated for evaluation of stroke patients, demonstration of cryptococcal yeast forms in CSF is valuable in guiding appropriate therapy in arterial stroke caused by Cryptococci. Herein, we describe the CSF and radiologic correlation in a female patient who presented with disseminated cryptococcosis, cryptococcal meninigitis and a middle cerebral artery infarct.
authors.affiliation: Department of Neuro-Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: David
authors.initials: D
authors.lastname: Cachia
authors.affiliation: Division of Cytopathology, Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Charanjeet
authors.initials: C
authors.lastname: Singh
authors.affiliation: Division of Dermatopathology, Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Tetzlaff
authors.affiliation: Department of Neuro-Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Marta
authors.initials: M
authors.lastname: Penas-Prado
mesh_terms: D000368:Aged; D003453:Cryptococcosis / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D003455:Cryptococcus neoformans / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D016919:Meningitis, Cryptococcal / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D020768:Middle Cerebral Artery / Q000382:microbiology / Q000473:pathology*; D020521:Stroke / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology
keywords: cryptococcal meningitis; disseminated cryptococcosis; lymphoma; stroke