Cryptococcal Meningitis in a Young Obese Female with Takayasu Arteritis and Idiopathic Intracranial Hypertension

Abstract

A 30-year-old African-American obese female, with hypovitaminosis D, was diagnosed with idiopathic intracranial hypertension and Takayasu arteritis 2 years before; symptoms improved with acetazolamide and immunosuppressive therapy. She then presented with headaches, photophobia, tinnitus, facial paraesthesiae, fatigue, and subjective night fevers. Brain imaging was normal. Lumbar puncture was performed, and spinal fluid fungal cultures grew Cryptococcus neoformans. Antifungal therapy was instituted with relief of symptoms. Immunosuppressive treatment for Takayasu arteritis was tapered. The authors report a unique case in the medical literature and would like to raise awareness of cryptococcal meningitis, as it can simulate idiopathic intracranial hypertension and cause a non-specific neurological syndrome. Risk factors, detection, and management are discussed.

KEYWORDS:

• Cryptococcal meningitis
• Takayasu arteritis
• Idiopathic intracranial hypertension

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.