Differential diagnostic difficulties in a case of probably spontaneous cryptococcus meningitis in a young girl are the reason for an extensive presentation of this case. The problems of CSF examination are discussed. In the course of the disease an intraventricular mycetoma had arisen, and caused the picture of a space-occupying process. Histological examination revealed an atypical reaction of the perifocal brain tissue, the possible causes of which are evaluated.