Neurosarcoidosis vs. Cryptococcal Meningoencephalitis: A Diagnostic Pitfall in a Sarcoidosis Patient

A 72-year-old man with possible sarcoidosis presented with transient dysarthria and left-sided weakness. Brain imaging and cerebrospinal fluid (CSF) findings initially suggested neurosarcoidosis. However, the patient’s clinical deterioration after steroid treatment and subsequent CSF evaluations confirmed cryptococcal meningoencephalitis. This case highlights that in patients with sarcoidosis presenting with neurological symptoms, alternative infectious etiologies such as cryptococcal meningoencephalitis should be carefully ruled out, even in the absence of overt immunodeficiency, since disease-related immune dysregulation may still be present in sarcoidosis.