{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T17:30:52Z","timestamp":1787679052887,"version":"build-2784847793"},"reference-count":11,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,5,15]]},"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:p>Cryptococcal meningitis is an opportunistic infection predominantly affecting immunocompromised patients but rarely can affect the immunocompetent. We describe a 53-year-old Caucasian man who presented complaining of a 2-week history of severe bilateral eye pain and diplopia. His only known risk factor was that he lived in a horse farm and recently shot bats and pigeons in his barn. He visited an outside hospital during this time without a diagnosis established. After further deliberation, we obtained a lumbar puncture (LP) which revealed an opening pressure (OP) of 27\u2009cm H<jats:sub>2<\/jats:sub>O. Cerebrospinal fluid (CSF) and fungal cultures confirmed the presence of <jats:italic>Cryptococcus neoformans<\/jats:italic>. The patient was diagnosed with <jats:italic>C. neoformans-<\/jats:italic>mediated meningoencephalitis and was initiated on the appropriate induction anti-fungal therapy. This case emphasises the need for clinicians to remain vigilant and consider cryptococcal meningitis in immunocompetent individuals even when classic symptoms of meningitis are absent.<\/jats:p>","DOI":"10.1136\/bcr-2019-230003","type":"journal-article","created":{"date-parts":[[2019,5,29]],"date-time":"2019-05-29T06:46:02Z","timestamp":1559112362000},"page":"e230003","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Rare presentation of cryptococcal meningitis in an immunocompetent patient"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9845-3427","authenticated-orcid":false,"given":"Ahmed","family":"Khattab","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunita","family":"Patruni","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary L","family":"Sealey","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,5,28]]},"reference":[{"key":"2025082622515321000_12.5.e230003.1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S38850"},{"key":"2025082622515321000_12.5.e230003.2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit641"},{"key":"2025082622515321000_12.5.e230003.3","doi-asserted-by":"publisher","DOI":"10.1086\/587667"},{"key":"2025082622515321000_12.5.e230003.4","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.3892\/etm.2016.3440","article-title":"Cryptococcal meningitis initially presenting with eye symptoms in an immunocompetent patient: A case report","volume":"12","author":"Li","year":"2016","journal-title":"Exp Ther Med"},{"key":"2025082622515321000_12.5.e230003.5","doi-asserted-by":"publisher","DOI":"10.1128\/EC.00039-10"},{"key":"2025082622515321000_12.5.e230003.6","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/S0377-1237(03)80003-5","article-title":"Cryptococcal Meningitis: A Clinicopathological Account of Seven Cases Encountered in a Military Setting","volume":"59","author":"Kapila","year":"2003","journal-title":"Med J Armed Forces India"},{"key":"2025082622515321000_12.5.e230003.7","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1202526"},{"key":"2025082622515321000_12.5.e230003.8","doi-asserted-by":"crossref","first-page":"136","DOI":"10.4103\/0972-2327.64646","article-title":"Idiopathic CD4 lymphocytopenia presenting as refractory cryptococcal meningitis","volume":"13","author":"Sharma","year":"2010","journal-title":"Ann Indian Acad Neurol"},{"key":"2025082622515321000_12.5.e230003.9","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1007\/s11940-001-0042-5","article-title":"Double Vision","volume":"3","author":"Lee","year":"2001","journal-title":"Curr Treat Options Neurol"},{"key":"2025082622515321000_12.5.e230003.10","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2876"},{"key":"2025082622515321000_12.5.e230003.11","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.neuchi.2018.05.178","article-title":"Cryptococcal meningitis in an immunocompetent patient with obstructive hydrocephalus: A case report","volume":"64","author":"Hamdan","year":"2018","journal-title":"Neurochirurgie"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-230003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T05:52:01Z","timestamp":1756273921000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-230003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5]]},"references-count":11,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,5,28]]},"published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.1136\/bcr-2019-230003"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-230003","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5]]}}}