Deafness in the Elderly – an Atypical Presentation of Cryptococcal Meningitis

Cryptococcus neoformans is the most common cause of fungal meningitis in both immunocompromised and immunocompetent hosts. Elderly patients account for one-third of cases and presentations are usually atypical. Sensorineural deafness is a common sign of aging but is also one of the complications of cryptococcus meningitis, occurring in more than a quarter of patients. Most of the deafness is bilateral and irreversible, hence devastating for the patient. Visual disturbance is not associated with sensorineural deafness in cryptococcal meningitis. Cryptococcal meningitis should be one of the differential diagnoses in patients with sudden onset of deafness with neurologic symptoms. A prompt diagnosis and directed treatment may prevent further complications of the disease.