Novel cryptococcal meningitis is caused by infection of the meninges and/or brain parenchyma by novel cryptococci. Due to its atypical symptoms and irregular treatment, the rate of misdiagnosis and morbidity and mortality is still high. In recent years, the incidence of the disease has increased with the widespread or inappropriate use of broad-spectrum antibiotics, hormones, immunosuppressive drugs, and an increase in the number of patients with immunodeficiency diseases and organ transplants. The pathogens are mostly inhaled from the respiratory tract, forming foci in the lungs and then disseminated to the meninges via the blood circulation. Examination 1. Cerebrospinal fluid Increased pressure, slightly mixed or yellowish in appearance, mild to moderate increase in protein content. The cell count is increased, mostly around 100×10/L, mainly lymphocytes. Chloride and glucose are mostly decreased. Cerebrospinal fluid smear with ink staining can directly detect cryptococci. Early cerebrospinal fluid examination, regardless of routine, biochemical and cytological are more than 95% abnormal. The main manifestation is inflammatory changes, 99% can be detected from the first lumbar puncture cerebrospinal fluid cryptococci, or new cryptococcal reverse latex agglutination test is positive, strong positive reaction. Therefore, cerebrospinal fluid examination is an important basis for confirming the diagnosis of cryptobrain. 2.Immunological examination Latex agglutination (LA) test can detect cryptococcal polysaccharide pod antigen component in serum or cerebrospinal fluid at the early stage of infection, this method has higher specificity and sensitivity than ink staining, and the positive rate of cerebrospinal fluid detection can be as high as 99%. If the antigen positive titer > 1:8, the diagnosis of active cryptococcal meningitis can be confirmed. The positive rate is related to the different stages of the disease, the longer the disease course, the higher the positive rate. Ventricular enlargement, hydrocephalus, meningeal enhancement and irregular large lamellar, patchy or corn-like low-density shadow in the brain parenchyma can be seen, and a few show small infarct foci or hemorrhagic foci. Cranial MRI may show a round or round-like mass with low signal in T1 and high signal in T2 in the brain parenchyma, enlarged perivascular space, and part of it shows multiple corn-like nodular changes. Treatment: 1.Amphotericin B (diphenomycin B) It can selectively bind to ergosterol on the fungal cell membrane, increasing the permeability of the cell membrane and causing extravasation of substances in the fungus leading to fungal death. 2.Fluconazole plays a fungicidal role by inhibiting cytochrome P-dependent enzymes and inhibiting the biosynthesis of cell membrane ergosterol. The drug can easily pass the blood cerebrospinal fluid barrier, and the concentration in the cerebrospinal fluid can reach about 80% of the plasma, so it is the drug of choice for patients with AIDS combined with cryptococcal meningitis. 3, 5-fluorocytosine This drug can easily cross the blood-cerebrospinal fluid barrier, but it is easy to produce drug resistance when applied alone, and has a synergistic effect when used with amphotericin B (AMB), which can reduce the dosage of amphotericin B and thus reduce its toxic effects. Once the disease is diagnosed, immediate antifungal treatment is required. The route and duration of treatment should be individualized, and the total duration of treatment is generally 2.5 to 11 months. The indications for discontinuation are: clinical symptoms and signs basically disappeared, cerebrospinal fluid (CSF), routine examination is normal, CSF direct microscopy and culture negative for 3-4 weeks (once a week), the total amount of amphotericin B reached 1.5-3 g. In addition, for increased intracranial pressure, mannitol and furosemide (tachyphylaxis) and other dehydrating agents are used, intracranial abscess or granuloma can be considered surgical removal, severe hydrocephalus feasible cerebrospinal fluid shunt and Enhance systemic nutritional support therapy.