Transient loss of consciousness caused by cryptococcal meningitis in an immunocompetent patient: a case reportReport as inadecuate




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Cases Journal

, 2:60

First Online: 15 January 2009Received: 24 November 2008Accepted: 15 January 2009DOI: 10.1186-1757-1626-2-60

Cite this article as: Wilbur, L. & Heyborne, R. Cases Journal 2009 2: 60. doi:10.1186-1757-1626-2-60

Abstract

An immunocompetent 51 year-old female presented to the Emergency Department ED with a chief complaint of transient loss of consciousness and was found to have cryptococcal meningitis. She complained of general fatigue and a -cramping- sensation in her right arm for one week. The physical exam was significant for the presence of a right homonymous hemianopsia and the absence of fever or signs of meningismus. A computed tomography CT of the brain was interpreted as showing an age-indeterminate infarct in the left parietal region. However, a magnetic resonance imaging MRI of the brain showed multiple areas of meningeal enhancement. Cerebrospinal fluid analysis revealed a positive cryptococcal antigen and 105 white blood cells. The patient was successfully treated with Amphotericin B and fluconazole. While cryptococcal meningitis is typically a disease of the immunocompromised, it can, as in this case, present in an immuncompetent host.

AbbreviationsmmHgmillimeters of mercury

gm-dlgrams per decilitre

k-cummthousand per liter

ASTaspartate aminotransferase

ALTalanine aminotransferase

units-Lunits per liter

mcmol-Lmicromoles per liter

mg-dlmilligrams per decilitre

mgmilligrams.

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Author: Lee Wilbur - Ryan Heyborne

Source: https://link.springer.com/







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