Case Report: combined surgical and pharmacological management of basal ganglia cryptococcal meningoencephalitis

Introduction Cryptococcal meningoencephalitis involving the basal ganglia is exceedingly rare and poses diagnostic and therapeutic challenges due to its tumor-mimicking presentation. This case underscores the necessity of a multidisciplinary approach integrating surgical intervention and targeted antifungal therapy. Case presentation A 47-years-old immunocompetent female presented with progressive headache and left-sided hemiparesis. Neuroimaging identified a basal ganglia mass initially misdiagnosed as a neoplastic lesion. Interventions Surgical resection under neuroelectrophysiological monitoring was combined with amphotericin B, flucytosine, and fluconazole. Outcomes Complete lesion excision, symptom resolution, and mild memory deficits at 4-years follow-up. Lessons Combined therapy is pivotal for CM with parenchymal involvement; early surgery may mitigate irreversible neurological sequelae.