Cryptococcal Meningitis in an Immunocompetent Patient with a Ventriculo-Pleural Shunt

Abstract

Cryptococcal meningitis is the most common form of infection caused by Cryptococcus yeast species, followed by pulmonary infection. It is an opportunistic infection seen in patients with impaired cell immunity, most frequently in HIV patients and solid organ transplant recipients; however, it can occur in patients with no apparent immunodeficiency. We describe the case of Cryptococcus neoformans meningitis in an immunocompetent patient with aseptic cerebrospinal fluid analysis which highlights the heterogeneity of this disease.

Figure 1

Mild to moderate cardiomegaly with atherosclerotic calcification along the aorta. Extensive patchy airspace opacities bilaterally. At least small sized layering right-sided pleural effusion (arrow). No detectable pneumothorax. Right-sided catheter/shunt along the chest wall, probably a ventriculo-pleural shunt.

Figure 2

Right parietal approach ventriculostomy catheter with catheter tip terminating in or along the anterolateral aspect of the left lateral ventricle (short arrow). Interval re-expansion of the left lateral ventricle and left frontal horn prior to previous examination (long arrow). Postsurgical changes related to right frontal craniotomy and chronic microvascular ischemic.