Cryptococcal meningitis is a severe infection in both immunocompetent and immunosuppressed hosts. This report is an unusual case of co-infection with cryptococcal meningitis and Japanese encephalitis in a seronegative human immunodeficiency virus patient. A 51-year-old human immunodeficiency virus-negative patient presented with high-grade fever, nausea, vomiting, and later on, behavioral changes. A lumbar puncture was performed and cerebrospinal fluid revealed the presence of Cryptococcus and Japanese encephalitis virus. Treatment commenced with intravenous amphotericin B and flucytosine. Her condition initially improved but later on deteriorated due to bacteremia (MRSA-mecA gene positive) and septic shock which resulted in the patient’s demise. The occurrence of this co-infection in the absence of HIV infection is rare and there was no documented case up to this date.
Meningitis, Cryptococcal ; Encephalitis, Japanese

We describe a 52-year old woman who developed one- and-a-half syndrome with an ipsilateral trigeminal and facial nerve palsy from a lacunar infarct of the left paramedian pontine area likely involving the median-paramedian perforators of the basilar artery.
Stroke, Lacunar ; Brain Stem