Neuromeningeal Cryptococcosis in an HIV Patient: The contribution of MRI

Neurocryptococcosis is a major opportunistic infection in immunocompromised individuals, the diagnosis of which relies on a close radiological-biological correlation. We report the case of a 71-year-old patient with AIDS presenting with fever and headaches; After a normal initial CT scan, brain MRI revealed nodular and patchy white matter abnormalities with T2/FLAIR hyperintensity and diffusion restriction, associated with vermis hypertrophy and hemorrhagic stigmata on T2*. Correlation with a bronchoalveolar lavage positive for Cryptococcus neoformans confirmed disseminated neurocryptococcosis in the form of cerebrospinal encephalitis. MRI is the gold standard for identifying the characteristic clinical features, including gelatinous pseudocysts and cryptococcomas. High-resolution MRI, combined with cerebrospinal fluid analysis, is proving to be an essential diagnostic tool for early management and improved prognosis.