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Case Reports in Infectious Diseases
Volume 2017 (2017), Article ID 4103858, 5 pages
https://doi.org/10.1155/2017/4103858
Case Report

Neurosyphilis with Concomitant Cryptococcal and Tuberculous Meningitis in a Patient with AIDS: Report of a Unique Case

Division of Infectious Diseases, Department of Medicine, University of Miami, Miller School of Medicine, Miami, FL 33136, USA

Correspondence should be addressed to Jose Armando Gonzales Zamora

Received 7 June 2017; Revised 30 July 2017; Accepted 31 July 2017; Published 27 August 2017

Academic Editor: Paola Di Carlo

Copyright © 2017 Jose Armando Gonzales Zamora et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Meningitis in individuals living with acquired immunodeficiency syndrome (AIDS) is most frequently infectious in origin and usually due to opportunistic infections. The most common pathogens are Cryptococcus neoformans and Mycobacterium tuberculosis. Treponema pallidum causes neurosyphilis and can complicate HIV infections at any time after the initial infection. Simultaneous infections of the central nervous system caused by these pathogens are very uncommon even in the setting of severe immunosuppression. We report the case of a newly diagnosed HIV/AIDS young man who was found to have neurosyphilis with Cryptococcus meningitis. After a few weeks of treatment and initiation of antiretroviral therapy, he was also diagnosed with tuberculous meningitis, which was probably unmasked by the development of immune reconstitution inflammatory syndrome (IRIS). To the best of our knowledge, this is the only case of reported neurosyphilis and meningitis caused concomitantly by Cryptococcus and Mycobacterium tuberculosis.