Cryptococcal Meningoencephalitis

A 47-year female presented with 6 months of episodic fever. She was evaluated by a paramedic in a local clinic and was treated with some antibiotics. Her symptoms improved transiently, but fever was persistent. Fever pattern was on and off type, with a maximum temperature of 102 °F, once or twice a month. She also had frequent headache, nausea, non-projectile vomiting, and pain around the nape of her neck for the last 4 months. There was no associated cough, shortness of breath, skin rashes, lumps, and nodes in axilla, neck, and groin, altered sensorium, abnormal body movements, or urinary symptoms. She had a history of hysterectomy 11 years back and was needed blood transfusion then. She consumes a mixed diet, is non-alcoholic, and neither smokes nor chews tobacco.