CD4 and meningoencephalitis: However, C. neoformans is not only a primary pathogen since fungal cells can be contained within lung granulomas in immunocompromised hosts for extensive periods of time but immunosuppressive conditions, such as CD4-lymphopenic HIV/AIDS patients, can cause granuloma breakdown, latent fungal cell proliferation, and brain dissemination potentially resulting in fatal meningoencephalitis (11, 31).