{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T21:31:33Z","timestamp":1792359093262,"version":"4.4.0"},"reference-count":24,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2023,6,27]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:p>\n                    A 21-year-old woman with multiple sclerosis (taking regular fingolimod) developed sudden-onset severe headache with nausea and malaise. Neurological examination was normal and she was afebrile. Blood results showed lymphocytes 0.53 x 10\n                    <jats:sup>9<\/jats:sup>\n                    \/L and C reactive protein 19 mg\/L. CT scan of head and venogram were normal. CSF showed an opening pressure of 33 cm H\n                    <jats:sub>2<\/jats:sub>\n                    O and an incidental light growth of\n                    <jats:italic>Cryptococcus neoformans<\/jats:italic>\n                    , confirmed with positive India Ink stain and a positive cryptococcal antigen (1:100). She was treated for cryptococcal meningoencephalitis with amphotericin and flucytosine. Her presenting symptoms had closely mimicked subarachnoid haemorrhage. This atypical presentation of cryptococcal CNS infection highlights the need for vigilance in immunosuppressed patients.\n                  <\/jats:p>","DOI":"10.1136\/pn-2023-003691","type":"journal-article","created":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T07:45:19Z","timestamp":1700725519000},"page":"512-515","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Cryptococcal meningoencephalitis in multiple sclerosis treated with fingolimod"],"prefix":"10.1136","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2265-6230","authenticated-orcid":false,"given":"Moneeb","family":"Nasir","sequence":"first","affiliation":[{"name":"The Royal London Hospital, Barts Health NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Galea","sequence":"additional","affiliation":[{"name":"Wessex Neurological Centre, University Hospital Southampton NHS Foundation 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