Cryptococcus Meningoencephalitis With Severe Localizing Neurological Deficits Mimicking a Large Right Middle Cerebral Artery Infarct in a HIV Patient

Fadi Tahhan; Argin Haritounian; Lisa Duong; Jessica Haugen; Antonio K Liu

doi:10.7759/cureus.14781

Cryptococcus Meningoencephalitis With Severe Localizing Neurological Deficits Mimicking a Large Right Middle Cerebral Artery Infarct in a HIV Patient

Cureus. 2021 Apr 30;13(4):e14781. doi: 10.7759/cureus.14781.

Authors

Fadi Tahhan¹, Argin Haritounian¹, Lisa Duong², Jessica Haugen³, Antonio K Liu²

Affiliations

¹ Internal Medicine, Adventist Health White Memorial, Los Angeles, USA.
² Neurology, Adventist Health White Memorial, Los Angeles, USA.
³ Family Medicine, Adventist Health White Memorial, Los Angeles, USA.

Abstract

Immunocompromised patients with Cryptococcal meningoencephalitis can develop focal neurological signs and symptoms. Stroke and abscess are usually the leading etiologies. Definitively localized non-fluctuating deficits mimicking a large middle cerebral artery (MCA) infarct without corresponding MRI findings is rare. Localized lobar cerebritis may be the underlying etiology. Despite having many different kinds of sequences, a significant pathological process can still evade MRI's detection. Diffusion-weighted imaging (DWI) abnormality has also been seen in pathology other than ischemic stroke.

Keywords: cryptococcus meningoencephalitis; hiv; mimicking infarct.

Publication types

Case Reports