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We report a patient with cryptococcal meningitis and recurrent episodes of painful third nerve palsy who was found to have cryptococcal invasion of the third nerve and vasculitis at autopsy.
Case report.
A 34-year-old African American man presented with headache and generalized weakness. His past medical history was remarkable for a 15-lb weight loss over the prior 2 weeks in association with nausea and vomiting. He described paroxysmal, excruciating headaches lasting 4 to 6 minutes each. The pain started in his left shoulder, then radiated to the back of his left neck and base of his skull, toward his left eye, and finally culminated as a bifrontal headache. He had tearing during the attacks as well as temporary blurriness and diplopia. His headache frequency varied from every 15 minutes to every 2 hours. Further review of systems was remarkable for recent weakness in his lower extremities, urinary incontinence, and pain down his left inner thigh.
His general physical examination was unremarkable. Neurologic …
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Letters: Rapid online correspondence
- Reply to Liu et al
- Episodic third nerve palsy with cryptococcal meningitis
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