Multifocal cryptococcosis diagnosis by peripheral lymph node aspirates in a cat

A 4‐year‐old, female, neutered, domestic shorthair cat presented with a 5‐day history of progressive inappetence, obtundation, vestibular ataxia and tetraparesis. Neurological examination findings on presentation were consistent with a multifocal localisation (central vestibular with cerebellar involvement). Magnetic resonance imaging of the head showed diffuse brain parenchymal swelling, foramen magnum herniation, diffuse meningeal contrast enhancement and lymphadenopathy (enlargement and marked contrast enhancement of the parotid, mandibular and medial retropharyngeal lymph nodes). Fine‐needle aspirates of the retropharyngeal and prescapular lymph nodes showed macrophagic and eosinophilic inflammation with multiple yeast organisms on cytology, consistent with Cryptococcus spp. The cat suffered a cardiopulmonary arrest following diagnosis, suspected secondary to severe brainstem compression. The findings emphasise that systemic cryptococcosis can cause severe clinical signs, including presumptive central nervous system dysfunction, as in this cat. Furthermore, this case adds to the limited descriptions of neurological presentations and imaging findings associated with cryptococcosis in companion animals in the United Kingdom.