Cryptococcal meningitis: resolution eight months after antifungal therapy

Abstract

A patient with meningitis due to Cryptococcus neoformans had high titers of cryptococcal antigen in her lumbar cerebrospinal fluid after six months of antimicrobial therapy. Antifungal therapy was discontinued after improvement in immunologic parameters occurred. Cryptococcal antigen was no longer detectable in lumbar cerebrospinal fluid eight months after stopping all therapy. Because the course of cryptococcal meningitis is quite variable and cryptococcal polysaccharide is immunosuppressive, recovery of immunologic function may have been coincidental with resolution of the infection rather than due to treatment with transfer factor. However, confirmation of improved immunologic function was helpful in deciding to stop antifungal therapy.