<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2448-8909</journal-id>
<journal-title><![CDATA[Medicina crítica (Colegio Mexicano de Medicina Crítica)]]></journal-title>
<abbrev-journal-title><![CDATA[Med. crít. (Col. Mex. Med. Crít.)]]></abbrev-journal-title>
<issn>2448-8909</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Medicina Crítica A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2448-89092024000300222</article-id>
<article-id pub-id-type="doi">10.35366/117788</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Evento vascular cerebral occipital secundario a criptococosis meníngea]]></article-title>
<article-title xml:lang="en"><![CDATA[Occipital ischemic stroke due to meningeal cryptococcosis]]></article-title>
<article-title xml:lang="pt"><![CDATA[Evento vascular cerebral occipital secundário à criptococose meníngea]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García Regalado]]></surname>
<given-names><![CDATA[Jacob]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aguirre Rolón]]></surname>
<given-names><![CDATA[Koritza]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sahagún Sigala]]></surname>
<given-names><![CDATA[Oscar Eduardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ruelas Tapia]]></surname>
<given-names><![CDATA[Gustavo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Espinoza Camacho]]></surname>
<given-names><![CDATA[José Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General de Zona no. 7  ]]></institution>
<addr-line><![CDATA[Lagos de Moreno Jalisco]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Unidad Médica de Alta Especialidad T1  ]]></institution>
<addr-line><![CDATA[León Guanajuato]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<volume>38</volume>
<numero>3</numero>
<fpage>222</fpage>
<lpage>225</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-89092024000300222&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-89092024000300222&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-89092024000300222&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  la meningitis por Cryptococcus es la causa más común de meningitis fúngica. Pacientes con algún tipo de inmunocompromiso son con frecuencia los más afectados, (por ejemplo, pacientes con VIH, diabetes mal controlada o uso de inmunosupresores) pero este factor de riesgo no es indispensable para su aparición. Sigue siendo considerada una enfermedad poco frecuente y los síntomas clínicos son inespecíficos, por lo que un alto grado de sospecha es necesario para el diagnóstico, en particular si las manifestaciones clínicas iniciales son atípicas.  Caso clínico:  hombre de 52 años con antecedente de diabetes en mal control. Acudió a valoración por datos clínicos de evento vascular cerebral occipital (amaurosis izquierda repentina) con posterior alteración del estado de alerta, fue diagnosticado con criptococosis por tinción de tinta china y tratado con anfotericina B liposomal. De manera subsecuente desarrolló muerte encefálica.  Conclusiones:  es importante la sospecha clínica en pacientes con síntomas neurológicos sin una etiología evidente y factores de riesgo para el desarrollo de criptococosis, ya que el diagnóstico y el tratamiento oportuno son claves para la supervivencia de estos enfermos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  cryptococcal meningitis is the most common cause of fungal meningitis. Patients with some kind of immunocompromise are the most frequently affected (for example patients with HIV, poorly controlled diabetes or use of immunosuppressors), but these risk factors are not absolutely needed for its appearance. It is still considered a rare disease and the clinical symptoms are nonspecific, a high degree of clinical suspicion is necessary for diagnosis, particularly if the initial manifestations are atypical.  Clinical case:  a 52-year-old man with clinical record of poorly controlled diabetes. He came for evaluation due to clinical data of an occipital cerebral vascular event (sudden left amaurosis) with subsequent mental status impairment, he was diagnosed with cryptococcosis by Indian ink staining and treated with liposomal amphotericin B. He subsequently developed brain death.  Conclusions:  clinical suspicion is important in patients with neurological symptoms without an obvious etiology and risk factors for the development of cryptococcosis, since diagnosis and prompt treatment are key to the survival of these patients.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução:  a meningite por Cryptococcus é a causa mais comum de meningite fúngica. Pacientes com algum tipo de imunocomprometimento são os mais frequentemente afetados (por exemplo, pacientes com HIV, diabetes mal controlado ou uso de imunossupressores) mas este fator de risco não é essencial para o seu aparecimento. Ainda é considerada uma doença rara e os sintomas clínicos são inespecíficos, pelo que é necessário um elevado grau de suspeita para o diagnóstico, principalmente se as manifestações clínicas iniciais forem atípicas. Relato de caso: homem de 52 anos com histórico de diabetes mal controlado. Apresentou-se para avaliação devido a dados clínicos de evento vascular cerebral occipital (amaurose súbita à esquerda) com subsequente alteração do estado de alerta, foi diagnosticado com criptococose por coloração nanquim e tratado com anfotericina B lipossômica. Posteriormente, ele desenvolveu morte encefálica.  Conclusões:  a suspeita clínica em pacientes com sintomas neurológicos sem uma etiologia óbvia e fatores de risco para o desenvolvimento de criptococose é importante, pois o diagnóstico e o tratamento oportunos são fundamentais para a sobrevivência desses pacientes.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[criptococosis]]></kwd>
<kwd lng="es"><![CDATA[meningitis criptocócica]]></kwd>
<kwd lng="es"><![CDATA[evento vascular cerebral isquémico]]></kwd>
<kwd lng="en"><![CDATA[cryptococcosis]]></kwd>
<kwd lng="en"><![CDATA[cryptococcal meningitis]]></kwd>
<kwd lng="en"><![CDATA[ischemic stroke]]></kwd>
<kwd lng="pt"><![CDATA[criptococose]]></kwd>
<kwd lng="pt"><![CDATA[meningite criptocócica]]></kwd>
<kwd lng="pt"><![CDATA[evento vascular isquêmico cerebral]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bloch]]></surname>
<given-names><![CDATA[KC]]></given-names>
</name>
<name>
<surname><![CDATA[Bailin]]></surname>
<given-names><![CDATA[SS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Update on fungal infections of the central nervous system: emerging pathogens and emerging diagnostics]]></article-title>
<source><![CDATA[Curr Opin Infect Dis]]></source>
<year>2019</year>
<volume>32</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>277-84</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Poley]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Koubek]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Walsh]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[McGillen]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cryptococcal meningitis in an apparent immunocompetent patient]]></article-title>
<source><![CDATA[J Investig Med High Impact Case Rep]]></source>
<year>2019</year>
<volume>7</volume>
<page-range>232470961983457</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pappas]]></surname>
<given-names><![CDATA[PG]]></given-names>
</name>
<name>
<surname><![CDATA[Perfect]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Cloud]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
<name>
<surname><![CDATA[Larsen]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Pankey]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
<name>
<surname><![CDATA[Lancaster]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cryptococcosis in human immunodeficiency virus-negative patients in the era of effective azole therapy]]></article-title>
<source><![CDATA[Clin Infect Dis]]></source>
<year>2001</year>
<volume>33</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>690-9</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Williamson]]></surname>
<given-names><![CDATA[PR]]></given-names>
</name>
<name>
<surname><![CDATA[Jarvis]]></surname>
<given-names><![CDATA[JN]]></given-names>
</name>
<name>
<surname><![CDATA[Panackal]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Fisher]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Molloy]]></surname>
<given-names><![CDATA[SF]]></given-names>
</name>
<name>
<surname><![CDATA[Loyse]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cryptococcal meningitis: epidemiology, immunology, diagnosis and therapy]]></article-title>
<source><![CDATA[Nat Rev Neurol]]></source>
<year>2017</year>
<volume>13</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>13-24</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ramírez-Ramos]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Galindo]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Correa]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Giraldo-Bahamon]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Rivera]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Solano]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Meningitis criptocóccica en pacientes sin infección por VIH: presentación de dos casos y revisión de la literatura]]></article-title>
<source><![CDATA[Rev Chil Infectol]]></source>
<year>2018</year>
<volume>35</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>716-21</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bracho-Navarro]]></surname>
<given-names><![CDATA[DF]]></given-names>
</name>
<name>
<surname><![CDATA[Cardona-Moica]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
<name>
<surname><![CDATA[Gómez-Ayala]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Gómez-Contreras]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Criptococosis meníngea en un paciente inmunocompetente]]></article-title>
<source><![CDATA[Med Int Méx]]></source>
<year>2023</year>
<volume>39</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>548-53</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mwaba]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Mwansa]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Chintu]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Pobee]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Scarborough]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Portsmouth]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical presentation, natural history, and cumulative death rates of 230 adults with primary cryptococcal meningitis in Zambian AIDS patients treated under local conditions]]></article-title>
<source><![CDATA[Postgrad Med J]]></source>
<year>2001</year>
<volume>77</volume>
<numero>914</numero>
<issue>914</issue>
<page-range>769-73</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mishra]]></surname>
<given-names><![CDATA[AK]]></given-names>
</name>
<name>
<surname><![CDATA[Vanjare]]></surname>
<given-names><![CDATA[HA]]></given-names>
</name>
<name>
<surname><![CDATA[Raj]]></surname>
<given-names><![CDATA[PM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cryptococcal meningitis presenting as acute onset bilateral cerebellar infarct]]></article-title>
<source><![CDATA[J Neurosci Rural Pract]]></source>
<year>2017</year>
<volume>8</volume>
<page-range>159-60</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zhou]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Lai]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Huang]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Xu]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Hu]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cryptococcal meningitis mimicking cerebral infarction: a case report]]></article-title>
<source><![CDATA[Clin Interv Aging]]></source>
<year>2018</year>
<volume>13</volume>
<page-range>1999-2002</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lan]]></surname>
<given-names><![CDATA[SH]]></given-names>
</name>
<name>
<surname><![CDATA[Chang]]></surname>
<given-names><![CDATA[WN]]></given-names>
</name>
<name>
<surname><![CDATA[Lu]]></surname>
<given-names><![CDATA[CH]]></given-names>
</name>
<name>
<surname><![CDATA[Lui]]></surname>
<given-names><![CDATA[CC]]></given-names>
</name>
<name>
<surname><![CDATA[Chang]]></surname>
<given-names><![CDATA[HW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cerebral infarction in chronic meningitis: a comparison of tuberculous meningitis and cryptococcal meningitis]]></article-title>
<source><![CDATA[QJM]]></source>
<year>2001</year>
<volume>94</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>247-53</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fugate]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[Lyons]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Thakur]]></surname>
<given-names><![CDATA[KT]]></given-names>
</name>
<name>
<surname><![CDATA[Smith]]></surname>
<given-names><![CDATA[BR]]></given-names>
</name>
<name>
<surname><![CDATA[Hedley-Whyte]]></surname>
<given-names><![CDATA[ET]]></given-names>
</name>
<name>
<surname><![CDATA[Mateen]]></surname>
<given-names><![CDATA[FJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Infectious causes of stroke]]></article-title>
<source><![CDATA[Lancet Infect Dis]]></source>
<year>2014</year>
<volume>14</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>869-80</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Katchanov]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Branding]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Jefferys]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Arastéh]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Stocker]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Siebert]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Neuroimaging of HIV-associated cryptococcal meningitis: comparison of magnetic resonance imaging findings in patients with and without immune reconstitution]]></article-title>
<source><![CDATA[Int J STD AIDS]]></source>
<year>2016</year>
<volume>27</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>110-7</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
