Cryptococcal meningitis is a disease that remains a significant cause of morbidity and mortality. This report describes the importance of conducting a detailed clinical investigation and the treatment challenges in cases of meningitis caused by Cryptococcus gattii. In recent years this species has received considerable interest due to its increased emergence and virulence.
Case presentation:
A patient with apparent good health (a fitness practitioner) showed symptoms including intermittent headache that became more intense and frequent when he began experiencing nausea, vomiting, dizziness and temporal headache without nuchal rigidity. The patient had human immunodeficiency virus-negative serology and had no chronic disease. Analysis of cerebrospinal fluid was performed and cryptococcal meningitis was diagnosed. Immunophenotyping by flow cytometry evidenced the presence of an anomalous lymphoid population. RFLP analysis of the URA5 gene indicated Cryptococcus gattii genotype VGII and considerable virulence was observed for the isolated strain.
Conclusion:
This case suggests the importance of a detailed investigation in patients who apparently have a competent immune system with meningitis caused by Cryptococcus spp., particularly C. gattii.
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