CD4 and cutaneous mastocytosis: Advanced HIV disease at diagnosis (CD4+ T-lymphocyte (CD4) count <200 cells/μl), high cerebrospinal fluid (CSF) fungal burden, sub-optimal management of cryptococcal meningitis (CM), delayed initiation of antiretroviral treatment (ART) and the presence of co-morbid conditions such as tuberculosis all contribute to the high case-fatality ratio (CFR) [4–6].