Fungal Meningitis

A young female patient, with a past history of Pulmonary Tuberculosis 7 years back, presents with


History:

1. Headache for 3 months
2. Diplopia for 1 month
3. Fever, low grade, no night sweats but history of weight loss and anorexia.

Clinical examination :

• Positive Kernig's sign
• Marked neck rigidity
• Depressed patient.
• Squint, lateral rectus palsy on right side.

CT scan revealed nothing remarkable, normal ventricles without any meningeal enhancement or Subarrachnoid Hemorrhage.

LP done which revealed 3+ yeast cells, which were later confirmed to be Cryptococcus.

Now she had received antifungal therapy, and also repeated Therapeutic LPs for raised intracranial pressure. We are planning for neurosurgical management (shunt placement) for relief of headache.



?What could have predisposed to all that?
















Patient has come out to be HIV +ve, which was later confirmed with ELISA. ART will be started soon.