A Rare Presentation of Cryptococcal Meningitis in a Treatment-Naive Patient with Sarcoidosis.

Cryptococcus neoformans is an encapsulated, yeast-like fungus that commonly lives in the environment due to soil contamination by the faeces of birds, especially pigeons. Cryptococcus is an opportunistic fungal infection frequently diagnosed in immunocompromised patients with HIV, steroid use, malignancy, history of organ transplantation, or, rarely, sarcoidosis. There have been only a few reports of cryptococcus infection in sarcoidosis patients who were not on steroid treatment. Here, we highlight the importance of considering opportunistic fungal infection in asymptomatic treatment-naive sarcoidosis patients. We present a patient with a history of asymptomatic, treatment-naive sarcoidosis who presented with headache and was diagnosed with cryptococcal meningitis in the presence of an idiopathic T-cell lymphopenia. LEARNING POINTS: Cryptococcus is an opportunistic fungal infection commonly diagnosed in immunocompromised patients.Sarcoidosis is a multi-systemic disease characterized by the formation of granulomas in various organs, most commonly found in the lungs and mediastinal lymph nodes. © EFIM 2021.