| Sumario: | The timing seems right to reintroduce clinicians and medical laboratorians to the important use of three rapid screening laboratory tests: cell count, India ink, and gram stain that presumptively identify Cryptococcus neoformans in cerebrospinal fluid. The tests are time sensitive and studies have shown the India ink to be 86%, gram stain 89%, and cell count 90% positive in patients co-infected with HIV and Cryptococcus neoformans, the leading cause of mortality and disability, in areas of Sub-Saharan African. The major environmental sources of Cryptococcus neoformans are soil contaminated with pigeon feces, and in fruits, vegetables, and trees. A 29-years-old male presented at the emergency room complaining of a headache, sensitivity to light, seizures, and stiff-neck. Upon admission, he was treated with Dilantin and Phenobarbital for the seizure, concurrently, with Amphotericin B and flucytosine every six hours for two weeks for cryptococcal meningitis. The concurrent use of the three rapid screening tests provided ease in detecting the pathogen, but their limitations can produce erroneous results and misdiagnosis. Serological replacement test may be considered, the urease and cryptococcal antigen test, but these tests are neither cost-effective nor routine. While no data was found on the statistical benefit in using these three tests concurrently, their individual use has yielded high sensitivity. It is assumed their benefits increase significantly when performed simultaneously; therefore, they are still preferred in the preliminary assessment of Cryptococcus neoformans, because they are routine, cost-effective, fast, and highly accurate, ideal especially for limited resource countries.
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