Report on the Cryptococcal Meningitis in Patient with Chronic Myeloid Leukemia

This study aimed to report the case of a female patient with chronic myeloid leukemia affected by
cryptococcal meningitis. ML, white, 48 years old, female sex, previously diagnosed with chronic
myeloid leukemia that has been refractive to the use of imatinib and who has recently begun using
nilotinib, was admitted complaining of sudden and disabling migraine in the last 1 month associated
with asthenia, adinamia, anorexia, disinterest for daily activities, dizziness, nausea, and vomiting. She
evolved with ataxia, and started to stroll with help and showed decrease of muscular strength in her
upper limbs. The cerebrospinal fluid showed presence of Cryptococcus sp. and, therefore, we began
treatment with intravenous liposomalamphotericin B in the dose of 3 mg/kg/day, for 6 weeks. A new
cerebrospinal fluid analysis, at the end of treatment, also showed rare structures that are compatible
with Cryptococcus sp. After stabilization and clinical improvement, she was discharged. After 3
weeks, she was hospitalized again with degeneration of the condition, and died due to intracranial
hypertension secondary to cryptococcal infection. This report reinforces the need of reflecting on fungi
pathologies, especially in immunosuppressant patients, as well as the importance of early diagnosing
and making a fast intervention, with the aims of providing quality of life and comfort to the patient and
of minimizing neurological sequelae to the patient.