AUTHOR=Zhang Fang , Li Yuchen , Shen Huijun , Tao Jie , Wang Jie 

TITLE=Case Report: Cryptococcal eosinophilic meningitis in a patient with Hodgkin lymphoma

JOURNAL=Frontiers in Neurology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.898525

DOI=10.3389/fneur.2022.898525

ISSN=1664-2295

ABSTRACT=Cryptococcal meningitis is the most common fungal meningitis in clinical practice. It primarily occurs in immunocompromised people and is typically associated with human immunodeficiency virus (HIV) infection. In rare cases, it is associated with Hodgkin lymphoma (HL). Eosinophilic meningitis (EM) is characterized by increased eosinophils in the cerebrospinal fluid (CSF) and is often caused by a parasitic infection of the central nervous system (CNS). EM caused by cryptococcal infection is rare; only two cases have been reported in the past 20 years. Here, we report a case of cryptococcal meningitis in a patient with HL who presented with an atypical eosinophil-predominant CSF cytology response. The patient’s eosinophil proportion reached 91%; a proportion this high has not been reported previously and may be associated with HL. After antifungal therapy and tumor chemotherapy, the proportion of eosinophils decreased significantly. This case indicates that cryptococcal infection of the CNS may present as EM, and HL should be considered if multiple lymph nodes are enlarged in patients with cryptococcal meningitis who have a very high proportion of eosinophils in the CSF.