DUAL INFECTIVE PATHOLOGY IN PATIENTS WITH CRYPTOCOCCAL MENINGITIS

Coinfection of the nervous system by two distinct nonviral organisms i s uncommon and often undiagnosed. Medical teaching emphasizes that a s ingle pathologic process should be sought; however, in the presence of severe immunocompromise this approach may not hold true. We describe seven HIV-1 seropositive patients with cryptococcal meningitis, three of whom had a proven nervous system infection with a second organism: concurrent tuberculous meningitis, a tuberculoma, and the first docume nted case of cryptococcal meningitis and neurosyphilis.