VCOM Louisiana Research Day Program Book 2024

between the two species is the observation that, unlike C. neoformans, C. gattii infection does not tend to opportunistically infect immunosuppressed individuals. Cryptococcus neoformans is most classically associated with exposure to bird droppings, though the exact relationship between exposure and disease is not clear. Resultant meningitis or meningoencephalitis is thought to result from inhalation of the organism from the environment into the respiratory tract, with hematogenous dissemination to the central nervous system (CNS), possibly with tropism to the CNS by Cryptococcus. As with most CNS infections, primary diagnostic assessment is made on analysis of CSF. A notable finding on lumbar puncture in cryptococcal meningitis is a marked elevation of opening pressure, which was not present in this patient’s case, as his opening pressure was 48 mmH2O. However, Cryptococcus neoformans most often present with a higher opening pressure, with CSF pressures exceeding 200 mmH2O. Conclusions: Cryptococcal meningitis immunocompetent individuals. As seen with this case, when immunosuppression is not evident, less-considered sources of minor immunosuppression need to be explored. These include but are not limited to, alcoholism, diabetes mellitus, chronic liver disease, and chronic kidney disease. Even so, cryptococcal meningitis without a known underlying immunocompromised state carries mortality of 12%, likely because accurate diagnosis is often delayed due to the frequently subacute nature of due to C. neoformans is a relatively rare diagnosis among supposed

symptom development and the nature of patient presentation. Management of cryptococcal meningitis is multifaceted, including antifungal therapy and control of intracranial pressure. Most patients will require a prolonged course of antifungal therapy, including induction, consolidation, and maintenance phases, as seen with this patient. After working with fellow healthcare providers in accurately diagnosing and hastily treating this patient, it has become that more evident that we must consider even the most rare of diseases, as we may ne treating unknowingly immunocompromised individuals, opening the door to a milieu of different diagnoses not normally considered in the average population.

72