Etiologies of leptomeningeal enhancement include: infection (viral, bacterial, or fungal), sarcoid, or neoplastic (lymphoma or carcinomatous).
In this case patient had a spinal tap and CSF demonstrated: (reference range)
- Color/appearance: Colorless, clear
- WBC: High 89 (0-10/UL)
- RBC: 12
- Neutrophils: High 11% (0-6%)
- Lymphocytes: High 86% (40-80%)
- Monocytes: Low 3% (15-45%)
- Glucose: 49 (40-70 MG/DL)
- Total Protein: High 118 (15-45 MG/DL)
- Gram Smear: No Cells Seen
- VDRL: nonreactive
- Indian Ink and Culture: Positive for C. neoformans.
The patient was diagnosed with Cryptococcal meningitis. There was no known history of HIV. The patient was also found to have a small left PICA infarct likely secondary to vacuities/spasm.