| dc.description.abstract |
Background: This case report emphasizes the need to recognize cryptococcus as a possible cause of meningitis in
non-HIV patients in Sub-Saharan Africa and to highlight the possibility of grave outcomes due to the paradoxical
immune response in diabetic patients with cryptococcus meningitis. It also highlights the need for widespread
availability of amphotericin-B and flucytosine in hospitals in Sub-Saharan Africa.
Case presentation: A 27 year old African lady was admitted with generalized tonic clonic seizures lasting 5 to 10 min.
These seizures were preceded by severe frontal headaches radiating to the occiput and neck and associated with
chills, photophobia and loss of consciousness. She was tachycardic and had tongue bites on the lateral aspects of
her tongue. Kernig’s and Brudzinski’s signs were positive. India ink was positive on two cerebrospinal fluid (CSF)
samples. She had hyperglycemia and glucosuria as well. She was diagnosed with cryptococcal meningitis in
diabetes and had a remarkable response to fluconazole monotherapy. She went home on maintenance dose of
fluconazole having made full recovery. and is currently on prophylactic doses of fluconazole.
Conclusions: With the rising prevalence of diabetes in Sub-Saharan Africa, coupled with the low levels of
adequate glucose control, cryptococcal meningitis should be considered in the differential diagnosis for diabetic
patients presenting with chronic headache, fever and neurologic deficits |
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