Neurosarcoidosis vs. Cryptococcal Meningoencephalitis: A Diagnostic Pitfall in a Sarcoidosis Patient

Kim, Kijeong; Lee, Seunghee; You, Hyae Lee; Koo, Yong Seo; Kim, Hyo Jae

doi:2026.44.3.216

J Korean Neurol Assoc > Volume 44(3); 2026 > Article

Case Report

Journal of the Korean Neurological Association 2026;44(3): 216-219. doi: https://doi.org/10.17340/jkna.2026.0022

신경사코이드증으로 의심되었던 크립토코쿠스수막뇌염 증례

김기정, 이승희, 유혜리, 구용서, 김효재

울산대학교 의과대학 서울아산병원 신경과

Neurosarcoidosis vs. Cryptococcal Meningoencephalitis: A Diagnostic Pitfall in a Sarcoidosis Patient

Kijeong Kim MD, Seunghee Lee MD, Hyae Lee You MD, Yong Seo Koo MD, PhD, Hyo Jae Kim MD

Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Corresponding Author: Hyo Jae Kim ,Tel: +82-2-3010-3881, Fax: +82-2-474-4691, Email: peacockbeer@naver.com

Received: March 29, 2026 Revised: May 6, 2026 Accepted: May 7, 2026 Published online: August 1, 2026

Abstract

A 72-year-old man with possible sarcoidosis presented with transient dysarthria and left-sided weakness. Brain imaging and cerebrospinal fluid (CSF) findings initially suggested neurosarcoidosis. However, the patient’s clinical deterioration after steroid treatment and subsequent CSF evaluations confirmed cryptococcal meningoencephalitis. This case highlights that in patients with sarcoidosis presenting with neurological symptoms, alternative infectious etiologies such as cryptococcal meningoencephalitis should be carefully ruled out, even in the absence of overt immunodeficiency, since disease-related immune dysregulation may still be present in sarcoidosis.

Key Words: Sarcoidosis | Cryptococcosis | Meningoencephalitis