CD4 and immunodeficiency disease: It has also been reported that no or mild meningeal contrast enhancement is demonstrated in HIV-infected patients due to their immunodeficiency and immunogenic incompetence in recognizing polysaccharide capsule of cryptococcal organism.11,12,24 In our group of patients with lower CD4 T cell count, the lesions commonly involved the central part of brain, with no detected contrast enhancement that is related to the compromised response to the infection.