Cryptococcal Meningitis Mimicking Acute Stroke in an Immunocompetent Patient: A Case Report

Abstract

Cryptococcal meningitis typically affects immunocompromised individuals, particularly those with HIV/AIDS. However, rare cases occur in immunocompetent hosts, leading to delayed diagnosis due to atypical presentations. We present a case of a 59-year-old previously healthy male who developed right-sided weakness and dysarthria, initially suspected to be a cerebrovascular accident. His clinical course included persistent headache, fever, and altered mental status. Initial imaging showed non-specific white matter changes, and cerebrospinal fluid (CSF) analysis later confirmed Cryptococcus neoformans infection. Treatment with amphotericin B and flucytosine led to resolution of symptoms. This case underscores the diagnostic challenges in identifying cryptococcal meningitis in immunocompetent patients and hig hlights the risks of diagnostic anchoring in stroke-like presentations.