CD4 and meningitis: This has shifted the focus toward prevention in HIV patients, specifically those with low CD4 (<100 cells/μL) [10], by screening and preemptive treatment of asymptomatic cryptococcal antigenemia (ACA) [11]. ACA, which is the presence of cryptococcal species in the blood without having symptoms of meningitis (fever, headache, stiff neck, and altered mental status), is a subclinical disease that may progress to cryptococcal meningitis within three to six weeks if left untreated [12].