Acute ischemic stroke revealing cryptococcal meningitis in an HIV-infected patient with a relatively preserved CD4 count: a case report.
Muneeb Ahmad, Muhammad Umair, Muhammad Zubair Akram
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Case in brief
A 28-year-old man with a long history of HIV presented with acute right-sided hemiparesis. Despite a CD4 count of 302 cells/mmÂł, brain imaging revealed an acute infarction in the left internal capsule and hydrocephalus. Cerebrospinal fluid analysis confirmed cryptococcal meningitis. The patient was treated with amphotericin B and fluconazole, leading to significant clinical improvement.
Diagnostic / clinical pearl
Clinicians should consider cryptococcal meningitis as a potential cause of acute ischemic stroke in HIV-infected patients, even with relatively preserved CD4 counts.
Why it matters
This case highlights the importance of early cerebrospinal fluid analysis in atypical presentations of opportunistic infections to improve patient outcomes.