title: Cryptococcal meningitis initially presenting with eye symptoms in an immunocompetent patient: A case report.
abstract: Although cryptococcal meningitis (CM) typically occurs in immunocompromised hosts, immunocompetent humans are susceptible to CM. In humans with an intact immune system, CM presents with signs and symptoms typical of meningitis, including fever, headache and neck stiffness. The present study reported the case of a female immunocompetent patient who presented visual blurring in both eyes and bilateral papilledema for ~1 month. Following hospital admission, the patient was diagnosed with optic nerve inflammation and was treated with intravenous methylprednisolone and oral prednisone. However, the initial symptoms failed to improve and the patient developed a headache. The microscopic examination and India ink test performed using the cerebrospinal fluid of the patient showed the presence ofCryptococcus neoformans. Following combined treatment with amphotericin B and fluconazole, the patient made a full recovery with total resolution of the initial symptoms. This case demonstrates that CM in immunocompetent patients may initially include eye symptoms, which may result in a delayed diagnosis of CM.
authors.affiliation: Department of Ophthalmology, Lishui Hospital Affiliated to Zhejiang University, Lishui, Zhejiang 323000, P.R. China.
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Stomatology, Lishui Hospital Affiliated to Zhejiang University, Lishui, Zhejiang 323000, P.R. China.
authors.forename: Peipei
authors.initials: P
authors.lastname: Wang
authors.affiliation: Department of Ophthalmology, Lishui Hospital Affiliated to Zhejiang University, Lishui, Zhejiang 323000, P.R. China.
authors.forename: Ling
authors.initials: L
authors.lastname: Ye
authors.affiliation: Department of Ophthalmology, Lishui Hospital Affiliated to Zhejiang University, Lishui, Zhejiang 323000, P.R. China.
authors.forename: Yanfang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Ophthalmology, Lishui Hospital Affiliated to Zhejiang University, Lishui, Zhejiang 323000, P.R. China.
authors.forename: Xiuzhen
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Ophthalmology, Lishui Hospital Affiliated to Zhejiang University, Lishui, Zhejiang 323000, P.R. China.
authors.forename: Songping
authors.initials: S
authors.lastname: Yu
keywords: cerebrospinal fluid; cryptococcal meningitis; immunocompetent; papilledema