Title: Cryptococcal Meningitis in Immunocompetent Patients<br/>Author: WanTsu Wendy Chang<br/><a href='http://umem.org/profiles/faculty/1322/'>[Click to email author]</a><hr/><ul style="caret-color: rgb(0, 0, 0); color: rgb(0, 0, 0); font-family: -webkit-standard;">   <li>    <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Cryptococcal meningitis is the most common fungal CNS infection that predominantly affects immunocompromised patients.</span></span></li>   <li>    <u><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><i>However, cases have been described in immunocompetent patients.</i></span></span></u></li>   <li>    <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Clinical presentation may include headache, fever, neck pain, nausea, vomiting, light sensitivity, seizure, or altered mental status.</span></span></li>   <li>    <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Neuroimaging is usually normal, though cryptococcomas, pseudocysts, and obstructing hydrocephalus can be seen.</span></span></li>   <li>    <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Diagnosis with LP include elevated opening pressure, mononuclear predominance of cell count, low glucose, high protein, India ink microscopy, Cryptococcal antigen testing, and CSF culture.</span></span></li>   <li>    <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Subacute symptoms contribute to delay in diagnosis which increases overall morbidity and mortality.</span></span></li>  </ul>  <p>   <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><strong><u>Bottom Line</u>:</strong> Consider cryptococcal meningitis even in immunocompetent patients.</span></span></p>