Fulminant cryptococcal meningoencephalitis after successful treatment of primary cutaneous cryptococcosis.

INTRODUCTION: Cryptococcal meningoencephalitis is a life-threatening disease affecting mainly immunocompromised hosts. CASE REPORT: We present a case of a 64-year-old immunocompetent patient, who initially developed a traumatic scalp skin infection due to Cryptococcus neoformans. The patient received oral fluconazole and subsequently liposomal amphotericin B due to the development of resistance with resolution of the infection. Two years later, during chemotherapy for newly diagnosed gastric and lung cancer, he developed fulminant cryptococcal meningoencephalitis, which did not respond to liposomal amphotericin B and flucytosine.
CONCLUSIONS: To our knowledge, this is the first case of fulminant cryptococcal meningoencephalitis following long latency after adequately treated primary cutaneous infection. GERMS.