cryptococcus neoformans meningoencephalitis in a patient with polyarteritis nodosa case of 59yearold male with chronic obstructive pulmonary disease and a number of comorbidities who has developed meningoencephalitis caused by cryptococcus neoformans var grubii with polyarteritis nodosa diagnosed during hospitalization was presented before evidence of meningoencephalitis the patient was being treated with ketoconazole and low doses of fluconazole 200 mgday for alleged candidiasis the dosage was increased 800 mgday following laboratory diagnosis of c neoformans based on positive latex agglutination test and biochemical identification of encapsulated yeast isolated from the blood and csf later the yeast identification was confirmed by sequencing analysis owing to inadequate clinical response fluconazole therapy was switched to voriconazole 400 mgday and later to intravenous amphotericin b 10 mgkg per day despite of a temporary stabilization and improvement which correlated with decline of cryptococcal antigen titers from 11024 to 18 after 6 weeks the patients underlying condition deteriorated due to severe pancolitis and serious nosocomial bacterial infections the patient died of multiorgan failure several days later our case demonstrates a possible connection between the development of lifethreatening cryptococcosis and an autoimmune vasculitis disease and emphasizes that the outcome of the management of cryptococcal meningoencephalitis is highly dependent on early diagnosis adequate treatment including dosage and last but not least control of underlying disease and risk factors