Uncommon clinical presentations and diagnostic difficulties of antiphospholipid syndrome associated with cryptococcal meningitis: A case study

Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by thrombosis and obstetric morbidity. We report a 23-year-old female with APS who developed cryptococcal meningitis (CM) following immunosuppressive therapy. Diagnosed via cerebrospinal fluid (CSF) culture and MRI showing infarction, she had concomitant renal and hepatic failure, making amphotericin B contraindicated. Consequently, an individualized regimen comprising voriconazole and 5-fluorocytosine (5-FC) was initiated, resulting in significant clinical improvement. This case underscores that CM is a serious opportunistic infection in patients undergoing immunosuppression for APS, highlighting the need for vigilant monitoring and tailored antifungal strategies for multi-organ dysfunction.