Cryptococcal meningitis mimicking vascular dementia

Cryptococcosis is often seen in patients with compromised cellular immune response, particularly in those with AIDS. However, up to 30% of cases are reported in patients with no predisposing condition.1 Subacute meningitis is the most common presentation of cryptococcosis; it may be steadily progressive for weeks, months, and sometimes years. We describe a man aged 57 years referred for evaluation of neurobehavioral changes that developed within 1 month after transient hemiparesis. MRI revealed subcortical lesions, initially diagnosed as lacunes. Cryptococcal meningitis (CM) was diagnosed only 2 years later after abrupt deterioration. A man aged 57 years was referred for evaluation of progressive memory impairment and apathy of 1-year duration, which began within 1 month after an episode of left hemiparesis. Medical history included vertigo and two transient episodes of right hemiparesis. MRI …