Cryptococcal meningitis in an HIV-negative patient with systemic lupus erythematosus

Cryptococcal meningitis (CM) is a life-threatening fungal infection of the central nervous system that can occur in immunocompromised individuals, including patients with systemic lupus erythematosus (SLE) receiving immunosuppressive therapy. We report a 36-year-old woman with SLE who presented with headache, fever, seizures, and progressive decline in consciousness. Cerebrospinal fluid (CSF) analysis confirmed Cryptococcus neoformans . The patient was treated with high-dose fluconazole followed by amphotericin B and required ventriculoperitoneal (VP) shunt placement for intracranial pressure control. Follow-up CSF showed laboratory improvement despite persistent positive cultures, with clinical recovery. This case highlights the importance of early recognition and CSF evaluation in SLE patients with neurological symptoms.