Cryptococcal Meningitis: Imaging Findings in an Immunocompetent Patient TD01-TD02
Dr. Erica Yee Hing,
Radiologist and Lecturer, Department of Radiology, UKM Medical Centre, Faculty of Medicine, Jln Yaacob Latif, Bdr Tun Razak, Kuala Lumpur, Malaysia.
Cryptococcal meningitis is a fatal central nervous system disease commonly affecting immunocompromised patients, and rarely affects immunocompetent patients. We report a 51-year-old previously well male who presented with giddiness, altered sensorium and intermittent fever. India Ink stain and cryptococcal antigen test of cerebral spinal fluid were both positive. Immunodeficiency screening was negative. Although MRI brain demonstrated several features that are characteristic, they are unfortunately non-specific. It is important to realise immunocompetence does not exclude one from contracting cryptococcal meningitis, and a high index of suspicion with consideration of various imaging differentials and biochemical markers is helpful in narrowing down the diagnosis.