Cryptococcal meningitis in a newly diagnosed diabetic patien
The present case has been published in the journal BMC Infectious Diseases.

A 27 year old lady was admitted with generalized tonic clonic seizures lasting 5 to 10 min. These seizures were preceded by severe frontal headaches radiating to the occiput and neck and associated with chills, photophobia and loss of consciousness.

She was tachycardic and had tongue bites on the lateral aspects of her tongue. Kernig’s and Brudzinski’s signs were positive. India ink was positive on two cerebrospinal fluid (CSF) samples. She had hyperglycemia and glucosuria as well. She was diagnosed with cryptococcal meningitis in diabetes and had a remarkable response to fluconazole monotherapy.

She went home on maintenance dose of fluconazole having made full recovery. and is currently on prophylactic doses of fluconazole.

Case learnings:-
- Cryptococcal meningitis should be considered in the differential diagnosis for diabetic patients presenting with chronic headache accompanied with fever and neurologic deficits.

- The response to fluconazole was satisfactory in this patient. However, effort should be made to avail the more effective combination of amphotericin B and flucytosine in resource poor setting.

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