LAUSR

A 56-year-old man was admitted in the emergency room for an episode of aphasia. A preliminary diagnosis of stroke was made, but neurological examination and brain scan did not support this diagnosis and a possible diagnosis of meningitis was made. During the last 3 months the patient lost 15 kg of weight. Laboratory tests revealed: hemoglobin 10.3 g/dl (reference value (RV): 13.0 – 17.5), leucocytes 8.7 (cid:1) 10 9 /L (RV: 4.0 – 11.0), platelets 354 (cid:1) 10 9 /L (RV: 150 – 450), cre-atinine 3.52 mg/dl (RV: 0.7 – 1.2), lactic acid dehydrogenase 471 U/L (RV: 100 – 250), C-reactive protein 21.2 mg/dl (RV: <0.5), procalcitonin 2.32 ng/dl (RV: <0.5). The cerebrospinal fluid (CSF) analysis showed: protein 32.4 mg/dl (RV: 15 – 45), glucose 51 ng/dl (RV: 40 – 70), <1 leu-cocytes/mm 3 (RV: <5) and some images of an encapsulated yeast (uni-cellular and with an abundant capsule), suggestive of Cryptococcus spp. (Figure 1). In the peripheral blood film, were observed some iso-lated black to blue circular inclusions inside of