We present a case of cryptococcal meningitis initially misdiagnosed as stroke. Our patient is a young man on longterm corticosteroid due to gouty arthritis, who presented with acute onset of left-sided body weakness. Computed
tomography of the brain revealed multifocal chronic lacunar infarcts with acute communicating hydrocephalus and
cerebrospinal fluid culture isolated Cryptococcus neoformans. He was subsequently treated with amphotericin B
and fluconazole but passed away due to multiorgan failure. This case report highlights the importance of considering
chronic meningitis as a differential diagnosis when encountering stroke in young and immunocompromised patients.