Disseminated Cryptococcosis in an Immunocompetent Older Adult: A Case Report

Cryptococcosis is a fungal disease of global distribution, with higher incidence in developed countries. It usually occurs in immuno suppressed patients and is associated with high morbidity and mortality. Its disseminated presentation is very rare in immunocompetent individuals, and in older adults it increases the risk of mortality due to its a typical presentation and the physiological changes associated with aging. We present the case of an 83-year- old woman with acute confusional syndrome, hypoactive motor subtype, who progressed to stupor, and had functional decline of rapid onset. She presented signs of meningeal irritation, so a lumbar puncture and meningeal film array was performed. The array was positive for Cryptococcus. HIV serology was obtained, which was non-reactive. Other causes of immunosuppression were ruled out and given that the serum antigen for Cryptococcus neoformans was reactive in 400 dilutions, it was considered a case of disseminated cryptococcosis in an immunocompetent patient.