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January 1964

Ophthalmologic Complications of Cryptococcal Meningitis

Author Affiliations

St. Louis; Bethesda, Md
From the Ophthalmology Branch, National Institute of Neurological Diseases and Blindness (Dr. Okun), and the Laboratory of Clinical Investigations, National Institute of Allergy and Infectious Diseases (Dr. Butler), National Institutes of Health, US Public Health Service, US Department of Health, Education and Welfare.

Arch Ophthalmol. 1964;71(1):52-57. doi:10.1001/archopht.1964.00970010068009

Cryptococcosis, a systemic fungal disease caused by Cryptococcus neoformans often becomes perceptible to the patient only after localization in the central nervous system.1 Headache is the most common initial complaint, but is usually associated with other symptoms, including mental and visual changes, nausea and vomiting, neck pain, feverishness, and weakness.2 Sometimes such symptoms are a reflection of elevated cerebrospinal fluid pressure, and this is especially true for the ophthalmologic complaints. The ocular complications which have been reported include photophobia, diplopia, ptosis, amblyopia, nystagmus, ophthalmoplegia, anisocoria, papilledema, neuroretinitis, and primary optic atrophy.3 In rare instances, clinically apparent cryptococcal infection may be localized to the eye3,12; however, most frequently eye involvement is either the result of direct extension to the optic nerve via the subarachnoidal space, or associated with widespread disseminated disease.1

Untreated, cryptococcal meningitis is almost always a fatal disease, sometimes with a prolonged course.4

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