Rituximab-associated cryptococcal meningitis in systemic lupus erythematosus: A case report

We report a 41-year-old woman with systemic lupus erythematosus who developed cryptococcal meningitis five months after a second rituximab cycle. Initial symptoms mimicked an SLE flare, delaying diagnosis. Worsening neurologic deficits prompted lumbar puncture, revealing findings consistent with fungal meningitis and CSF culture positive for <i>Cryptococcus neoformans</i>. Treatment with amphotericin B and fluconazole resulted in clinical improvement, highlighting the diagnostic challenges and the need for early evaluation in immunosuppressed SLE patients.