Cryptococcal meningitis in apparently immunocompetent patients: association with idiopathic CD4+ lymphopenia

Pract Neurol. 2018 Apr;18(2):166-169. doi: 10.1136/practneurol-2017-001800. Epub 2017 Dec 9.

Abstract

We present two cases of cryptococcal meningitis in people subsequently diagnosed with idiopathic CD4+ lymphopenia. Both presented with new onset headaches without sinister features and were sent home on multiple occasions from emergency departments. Cryptococcal meningitis in HIV-negative patients poses major diagnostic and management problems; the associated mortality is 9%-27%. We suggest performing blood and cerebrospinal fluid cryptococcal antigen tests in all people with lymphocytic meningitis.

Keywords: infectious diseases; lymphopaenia; meningitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • CD4-Positive T-Lymphocytes / immunology*
  • Female
  • Humans
  • Lymphopenia / complications*
  • Lymphopenia / immunology
  • Male
  • Meningitis, Cryptococcal / complications*
  • Meningitis, Cryptococcal / immunology
  • Middle Aged