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  • Cryptococcal meningitis due to Cryptococcus gattii in an immunocompetent patient: uncommon presentation of a thunderclap headache

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Case Reports: Reminder of important clinical lesson
Cryptococcal meningitis due to Cryptococcus gattii in an immunocompetent patient: uncommon presentation of a thunderclap headache
  1. Marcela Garcia-Villa1,
  2. Arturo Gonzalez-Lara2 and
  3. Ildefonso Rodriguez-Leyva2,3
  1. 1Hospital Star Medica Morelia, Neurology Service, Outpatient Clinic, Morelia Michoacan, Mexico
  2. 2Neurology, Hospital Central Dr Ignacio Morones Prieto, San Luis Potosi, Mexico
  3. 3Neurology Department, Facultad de Medicina, Universidad Autonoma de San Luis Potosi, San Luis Potosi, Mexico
  1. Correspondence to Dr Ildefonso Rodriguez-Leyva; ilrole{at}yahoo.com.mx

Abstract

Thunderclap headache is a medical emergency presented as the worst headache ever, is characterised by an abrupt onset and maximal intensity within seconds to minutes. However, cerebrovascular causes are among the most common causes of thunderclap headache, and other non-vascular life-threatening aetiologies should be considered in evaluating a patient. We describe a 23-year-old previously healthy Latino woman who presented to our hospital after a month of repetitive severe, abrupt-onset headaches. Her prior medical history was unremarkable. After a normal brain MRI with angio-MRI, a lumbar puncture was performed with normal opening pressure, hypoglycorrhachia, increased proteins and a leucocyte; India ink staining was positive for encapsulated yeast, cultures were positive for Cryptococcus gattii. The patient received appropriate antifungal treatment with a good response. This case highlights the particular presentation of cryptococcal meningitis due to C. gattii among immunocompetent patients.

  • Cryptococcosis
  • Infections
  • Neurology (drugs and medicines)
  • Infectious diseases
  • Meningitis

https://doi.org/10.1136/bcr-2021-246158

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    Footnotes

    • Contributors IR-L is the author of correspondence. He has the right to grant and grants on behalf of all authors. In addition, he gives an exclusive license to BMJ Publishing Group Ltd ('BMJ') and its licensors to allow this work. In the case of acceptance, to be published in BMJ Case Reports and any other BMJ product and exploit all rights as set out in our license. MG-V, AG-L and IR-L participated as authors in the planning, writing and editing of the report.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.