A case report of Cryptococcal meningitis presenting with psychiatric abnormalities

authors:

avatar Mingyi Wo 1 , avatar Yongze Zhu 2 , avatar Tao Jiang 2 , avatar Youqi Ji 1 , avatar Yumei Ge 1 , 2 , *

Zhejiang Chinese Medical University
Zhejiang Provincial People's Hospital
Jundishapur Journal of Microbiology: Vol.17, issue 4; e146577
published online: May 06, 2024
article type: Case Report
revised: April 12, 2024
DOI: https://doi.org/10.5812/jjm-146577

how to cite: Wo M, Zhu Y , Jiang T, Ji Y, Ge Y. A case report of Cryptococcal meningitis presenting with psychiatric abnormalities. Jundishapur J Microbiol. 2024;17(4):e146577. https://doi.org/10.5812/jjm-146577.

Abstract

Background: Cryptococcal infection is a significant pathogen causing meningitis, often manifesting early with psychiatric abnormalities. Due to the lack of other specific symptoms, these behavioral changes are frequently misattributed to other mental disorders or overlooked, leading to delays in diagnosis. 
Objectives: This article reports on the diagnosis and treatment process of a patient with cryptococcal meningitis, and summarizes the abnormal behavior in terms of mental and behavioral aspects of cryptococcal meningitis patients, providing reference for the diagnosis and treatment of cryptococcal meningitis. 
Methods: We present a case of Cryptococcal meningitis where the initial abnormal behaviors were initially attributed to stress, resulting in a lack of emphasis on Cryptococcal treatment and subsequent failure of standard anti-infective therapy. In the end, we discovered abnormalities through cerebrospinal fluid examination and conducted targeted tests on Cryptococcus, resulting in a clear diagnosis and timely adoption of correct treatment measures. 
Results: The patient's condition improved and was agreed to be discharged. 
Conclusions: It is crucial for clinicians to deepen their understanding of Cryptococcal meningitis. When encountering patients with unexplained fever accompanied by psychiatric behavioral changes, a high suspicion for Cryptococcal infection should be maintained.