An Acute Case of Cryptococcal Meningitis in an AIDS Patient

Sometimes Fish Stories are actually true.  I mean, actually true.

I get asked a lot to tell the most fantastical, the most improbable story about Homeopathy I can possible come up with.  The one that a documentary filmmaker would travel the world to get her hands on.

It is an absoulte doozie.

So, turn off your phone and pour yourself a cup of tea.  This case a bit long, but you’ll be on the edge of your chair the entire time…


An Acute Case of Cryptococcal Meningitis in an AIDS Patient

November 3, 1987

In the fall of 1986, PD., a 37 y.o. homosexual male, consults his family physician for a persistent dry cough of 10 months duration. Oral antibiotics are prescribed. PD then develops a persistent diarrhoea with continuous and debilitating pain in the left hypochondria. Various medications are prescribed to no avail. In February 1987, PD has now lost 13 pounds at which time the HIV antibody test is found to be positive. During the summer of 1987, he complains of a recurring sore throat, cough, fever and night sweats which are particularly profuse from the knees down. He develops a severe case of oropharyngeal thrush with a hairy tongue. He continues to slowly deteriorate with more fever, sweats, sore throat, exhaustion, further loss of weight in spite of consulting with two AIDS specialists, one naturopathic physician and a Chinese herbalist. In mid-September he develops a strep infection. After a new course of antibiotics he develops an allergic rash. Two weeks later he is hospitalized with pneumocystis carinii pneumonia (PCP). Septra, an antibiotic, is given IV (intravenously) around the clock. A long series of adverse reactions to medication follows. Two weeks later (now mid-October), he is released having somewhat recovered from the pneumonia. During his last 2 days in the hospital he had started to experience heaviness of the head with achiness of the eyes. Three days after his release, PD is readmitted for acute cryptococcal meningitis, a very insidious and often fatal form of meningitis. Amphotericin B is given IV in high doses around the clock. Another antibiotic, flucytosine is given orally. Lastly, 1OO mg of corticosteroid is added to the IV antibiotics to counteract the severe adverse effects of antibiotic therapy which PD experiences as severe headaches, nausea, vomiting, cramps, spasms, fever, photophobia and general weakness. PD’s condition further deteriorates in the following week. He is vomiting several times a day, a green-brownish vomitus and develops pitting edema in both legs with persistent kidney pains (One of the most serious adverse effects of amphotericin B is kidney failure). His liver is enlarged and tender. His hemoglobin is 6.0 and Potassium 2.7 mmol/ (N: 3.5.-5). The general pains are so severe that morphine is administered and the physicians advise the family and friends that PD is not responding to the therapy and they can expect the worst. Late in the evening of November 3, I received a phone call from PD’s friend asking if homeopathy could help at this time. I take PD’s case on the phone.

Here are the characteristic symptoms described by his friend: He is semi-conscious with incoherent speech, extreme weakness with great restlessness and fear of dying. He desires company and he has cracked lips, extreme sensitivity to light and the slightest noise, especially voices.

Ass: Prognosis is fair because the remedy is so well indicated.

Plan: [Remedy #1] every two hours.

November 4, 1987:

The first dose of the remedy was given at 1pm during complete unconsciousness. Fifteen minutes later he is said to have smiled. Soon after, his overall condition improves dramatically.

November 5, 1987:

He is hungry and eats his first 3 meals in 6 weeks to the total amazement of the “assisting” medical staff.

November 8, 1987:

His general condition continued to improve until this morning. Now he is experiencing the following characteristic symptoms: dryness of the tongue with loss of taste worse on waking, burning soles, painless diarrhea early in the morning and burning itching hemorrhoids. The pain in the kidneys and liver and the edema of the lower extremities are still unchanged.

Ass.: We now have a change of picture. [Remedy #2] is here clearly indicated.

Plan: [Remedy #2] three times a day.

November 11, 1987:

His general condition continues to improve until this morning. He is relapsing into the first state, i.e.: great weakness with restlessness and fear of death.

Ass.: Relapse of the first stage.

Plan: [Remedy #1] every four hours.

Later that day, I am able for the first time to talk directly to the patient on the phone. I suggest that the best chance for him to recover, not only from the present condition but also from the chronic disease of general immune deficiency, is to first stop the steroids and later the antibiotics and to leave the hospital. PD is very reticent to stop the drugs but with the encouragement of his friend he agrees. So, on the evening of November 11, the steroids are stopped.

November 12, 1987:

PD now experiences the severe side effects of the antibiotics which had been checked by the steroids. The symptoms are great chills with very high fever worse from slight uncovering and from motion, very nervous and irritable from any external impression and he wants to be alone. Potassium: 3.0 mmol/L.

Ass.: We have a change of picture clearly indicating [Remedy #3].

Plan: [Remedy #3] every two hours.

His general condition improves further; he eats and smiles. The doctors and nurses are rather puzzled at the changes and think that the antibiotics are working after all. The infectious disease specialists are still pressing PD to take the oral antibiotic flucytosine that PD had previously asked to be stopped. PD refuses.

November 14, 1987:

Serum potassium is now 3.5 and the hemoglobin up to 8.7.

November 16, 1987:

The symptom picture has again changed: he has profuse night sweats, sleeplessness, loss of appetite, and burning /itching hemorrhoids.
Plan: [Remedy #2] three times a day.

November 17, 1987:

He feels better and informs his doctors that he wants to leave the hospital within a few days. The night sweats have stopped and the appetite has returned. The serum potassium is now normal at 4.2 mmol/L. By the evening, the symptomatology changes: he has a high fever with aversion to uncovering, thirstless during the heat and perspiration of the left side of the body only.

Ass.: We have a clear picture of [Remedy #4].

Plan: [Remedy #4] every four hours.

November 18, 1987:

He feels better again. A lumbar puncture (LP) is performed to assess the state of the CNS infection. The cryptococcus is still present in the spinal fluid. His hemoglobin is now 9.0. PD’s state is stable but he suffers from severe headaches (since the LP), which are better by stooping.

Ass.: I interpreted the symptom in the repertory of headaches worse tapping on spine as headaches from tapping the spine.

Plan: [Remedy #5] every two hours

November 20, 1987:

The headaches stay unchanged after the last prescription. PD stops the antibiotics against all medical advice. He still had 4 more weeks of IV antibiotic therapy to complete.

November 21, 1987:

This morning, PD leaves the hospital. He is told that, without a doubt, the meningitis will become fulminant and that he will die within a few days if he does not resume the antibiotherapies. By 11 a.m. the symptoms of meningitis are returning rapidly: heaviness around the eyes, rigidity of the neck, headache which is worse from flexion, sensitivity to light and slight noise especially voices, very irritable worse if spoken to, chilliness, restlessness, incoherent speech and great weakness. He does not drink but often wets his cracked lips with warm water.

Plan: [Remedy #1] every two hours.

Two hours later his general condition improves again. He continues to improve until the morning of November 25 at which time he experiences a mild relapse.

Ass.: Same picture but relapsing.

Plan: [Remedy #1] every two hours.

He started to smile 5 minutes after receiving the first dose and within 10 minutes fell asleep for 45 minutes. His energy is much better and most of the symptoms are much less. By 7pm he is experiencing a relapse again: heaviness of the head which is worse walking, eye pain worse looking upward, irritability and desire for salt and sweets.

Plan: [Remedy #2] every two hours.

November 27, 1987:

Within 15 minutes after the first dose, his energy picked up, he got up, smiled and went to the refrigerator as if everything was normal. On the morning of November 27, he was feeling good enough to have his chronic case taken on the phone. He describes himself as a loner, a shy and introverted person who prefers to be by himself. He worries about the future and disease (2), especially about contagious diseases (2). All his life he has had fear of microbes. He is fastidious about cleanliness (3) and conscientious about trifles (2). He has vertigo in high places (1) and has fear of the dark (2), death, narrow places and of public speaking (2). He dwells on past disagreeable occurrence. He is chilly (2) worse cold room. He desires farinaceous (2), meat (2), salt (2) and garlic. His face and back are oily and he has tendency for hangnails.

Ass.: No clear differentials but the closest remedy looks like [Remedy #6].

Plan: [Remedy #6] one dose.

November 29, 1987:

Within one hour his energy picked up and the overall picture improved. He continued to improve until the morning of November 29. He wakes up almost in a state of stupor, with great heaviness of the head, very irritable, frowning, melancholic, talks about his homeland, very slow to answer (3), aversion to company, reproaches himself, thirsty for cool drinks and has the sensation of a hair in the throat on swallowing.

Ass.: He has a relapse of the meningitis with a clear picture for [Remedy #7].

Plan: [Remedy #7] every hour and then as needed.

December 10, 1987:

His energy soon returns, the stupor disappears, the appetite returns and he starts to read and be active. An eczematous eruption has appeared on the leg, a symptom which he has had for the past 3 years until about 10 months ago. He took the remedy about three times a day and continued to improve until December 10. Coryza after eating, heat of the face with coryza, throbbing headache on stooping and desire for meat and fat. Ass.: A clear change of picture.

Plan: [Remedy #3] every six hours.

December 16, 1987:

He improved until today. He now experiences pain at the root of the nose, dryness of the throat on waking and expired air feels hot (3).

Plan: [Remedy #8] three times a day.

December 27, 1987:

By now, he is well recovered.

Plan: Stop the [Remedy #8] and wait.

December 30, 1987:

He is very chilly (3), irritable when questioned (3), and has despair of recovery (3), fear of death (3), but desires to be alone (3).

Plan: [Remedy #3] one dose.

January 12, 1988:

I meet PD for the first time. The eczema has now erupted in both external ear canals and has spread to the left leg. He has been chilly in the last 2 weeks on the left side of his body only (3), heat after eating (2) and great loss of hair (3). I further investigate his chronic case now that he is more coherent. He has never felt normal, has felt different and excluded, conscientious about trifles (3), chronic worrier, very self conscious, anticipation (3) and lack of self confidence (3). He hates himself. He is uncomfortable in the presence of others from being constantly humiliated and diminished since early childhood by his father. He was told repeatedly that he was good for nothing. He hated his father until a few years ago when he died. He suppresses his anger and refuses consolation. Since the age of 3, he has had diarrhea with tympanic distension every day before going to school or when anxious.

Plan: [Remedy #9] four times a day.

January 27, 1988:

PD feels much better overall. He feels more normal. Within a week of taking the last remedy, he felt less anxious, less irritable, much less obsessed about trifles and stronger. He feels warmer and now desires the open air. Hair falling is less with itchiness and offensive discharge from the scalp. The eczema has now spread upwards to the waist. The serology shows the sedimentation rate at 55 mm/h, the hemoglobin at 10.7 and the liver enzymes are normal for the first time in months.

Plan: [Remedy #9] four times a day.

February 9, 1988:

He feels “normal”. He feels strong. The mind is clearer. He is less irritable and more self-confident. The scalp and the eczema is worse. He desires open air (3).

Plan: [Remedy #9] four times a day.

February 18, 1988:

He is relapsing. He has difficulty to think, “when I want to think about something the mind goes around it and goes nowhere, I can’t focus the mind, the mind is stationary, I can’t read or concentrate,” staring for hours, throbbing headache, body feels heavy and the eczema is less. Ass.: He has a relapse of the meningitis.

Plan: [Remedy #7] every two hours.

February 22, 1988:

He recovered quickly and was better until this morning. Now he can’t open the eyes, with great exhaustion and depression that is worse 3-6 p.m.

Ass.: A change of picture.

Plan: [Remedy #10] three times a day.

February 24, 1988:

There is no change. Now, he has a sore throat that is worse on the right side, he desires sweets and he was irritable on waking.

Plan: [Remedy #9] twice a day.

March 8, 1988:

He improved progressively. His energy is much better by walking in the open air and he is weaker in a warm room. He is starting to feel a state of depression which he has had since his early twenties. He feels suicidal (by poisoning). He is angry and breaks things. His hemoglobin is up to 11.3.

Plan: [Remedy #9] three times a day.

March 18, 1988:

He feels much better. The depression has lifted and the mind is very clear. His appetite and energy are very good. The eczema is worse, it has now spread to the face. The hair falling is 50% better. Serology of March 10: hemoglobin: 11.4 and ESR: 58.

Plan: [Remedy #9] three times a day.

April 5, 1988:

He is feeling pretty good mentally and emotionally. “It seems this remedy provides me clarity. I can think and express myself better.” The concentration is good; he can read straight for up to two hours. His energy is almost normal, about 8 out of 10, the best in over one year. He goes out for long walks three times a day and enjoys it. He does one hour of weight lifting every other day. In general all the symptoms are better except for the eczema which has spread upwards from the legs, to the abdomen and chest, then to the neck and face. The face is totally covered by the rash which is very itchy and is worse from undressing and the warmth of the bed. He demands some relief of the itchiness as it is also preventing from sleeping. He has had a watery coryza in the morning for the past 18 days. He has been feeling warmer.

Plan: [Remedy #2] twice a day.

April 13, 1988:

The rash and the itchiness are much worse since the last remedy. The head is now affected and there is much dandruff. He feels also much warmer with flushes of heat and night sweats inside the thighs and behind the knees (2). The sleep is less because of the itchiness and he feels more tired.

Plan: [Remedy #2] twice a day.

April 21, 1988:

The rash and itchiness are decreasing. The dandruff is the same with thick brownish scales. He is sleeping 8 hours straight without waking. He had night sweats only last night in the lower back and the legs (between the knees and ankles). The energy is better. He feels good and steady emotionally. He has less flushes of heat. The coryza is unchanged. He was tested this week for syphilis and was seropositive for active infection. He contacted syphilis 10 years ago at which time he had a chancre on the penis.

Plan: [Remedy #2] twice a day.


Contrary to my advice, PD goes to Japan and stops homeopathic treatment. He returns three months later with another PCP. He decides to go back on antibiotics (he was told that these were “better ones”). In late October, I am asked to consult with him for the first time since last April. I visit him in a hospice. His energy is very low. I obtain almost no symptoms from him and find that I am unable to help him. He regresses further. Soon after he develops another cryptococcal meningitis. This time, the symptoms are less clear and he responds poorly. In December, while I am away, he dies in the hospice.


What would have happened if he had continued his homeopathic treatment? I cannot say.

What we know is that we treated probably one of the worst cases of compromised immunity in this patient with a full blown case of AIDS, pneumoncystic carinii pneumonia, cryptococcal meningitis, syphilis, high doses of very toxic antibiotics and antifungal drugs, high doses of steroids and lastly morphine. The patient is comatose with liver and renal failure and the question is, “Can homeopathy help?”

The answer is that with Pure Homeopathy this patient was recovering his health quickly until he interrupted his treatment.


This case is taken from André Saine’s clinic in Montréal. André is the Dean of the Canadian Academy of Homeopathy – the school where I’m currently a Fellowship candidate and a Master Hahnemannian.


HIV-infected patients with Cryptococcal Meningitis have a very poor prognosis.  A Cochrane review from 2015 found that bacterial meningitis is fatal in 20% to 50% of adults without AIDS, despite treatment with adequate antibiotics.


A Fish Story without the smell.

Over to you!

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