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Rare Case of Cryptococcal Meningitis in Patient With Idiopathic CD4 Lymphocytopenia

Cryptococcal meningitis is a serious and often fatal infection of the brain and spinal cord that is typically caused by a fungus called Cryptococcus neoformans. The fungus is usually found in soil and bird droppings, and it can be inhaled into the lungs. In people with a weakened immune system, the fungus can spread to the brain and cause meningitis.


Idiopathic CD4 lymphocytopenia (ICL) is a rare condition in which people have a low number of CD4 T cells, a type of white blood cell that helps the body fight infection. People with ICL are at increased risk for opportunistic infections, such as cryptococcal meningitis.

A recent case report published in the journal Cureus describes a rare case of cryptococcal meningitis in a patient with ICL. The patient was a 55-year-old woman who presented to the hospital with a two-week history of headache, fever, and confusion. She had no history of HIV infection or other underlying medical conditions.

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Laboratory tests revealed that the patient had a CD4 T cell count of 233 cells/μL, which is well below the normal range of 500-1,200 cells/μL. The patient also tested positive for cryptococcal antigen in the cerebrospinal fluid (CSF). CSF is the fluid that surrounds the brain and spinal cord.

The patient was diagnosed with acute cryptococcal meningitis and was started on treatment with amphotericin B and flucytosine. She responded well to treatment and was discharged from the hospital after two weeks. She was then continued on maintenance antifungal therapy for eight weeks.

This case report highlights the importance of considering the possibility of opportunistic infections in patients with ICL. Cryptococcal meningitis is a serious infection that can be fatal if left untreated. Early diagnosis and treatment with antifungal therapy is essential for a good outcome.

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