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Cryptococcus albidus (Naganishia albida) meningitis in a young patient with T-cell acute lymphoblastic leukaemia

Summary

A 16-year-old boy with blood cancer developed meningitis caused by a rare fungus called Cryptococcus albidus. Doctors initially thought he had a viral infection, but laboratory tests identified the fungus. He was treated with antifungal medications and improved significantly. This case shows how important it is to identify the correct cause of infection quickly, especially in patients with weakened immune systems.

Background

Cryptococcus albidus is an emerging pathogenic yeast that causes rare fungal infections, particularly in immunocompromised patients such as those with haematological malignancies. T-cell acute lymphoblastic leukaemia (T-ALL) predisposes patients to opportunistic infections due to immunosuppression. This case highlights the diagnostic and therapeutic challenges posed by C. albidus meningitis.

Objective

To report a case of C. albidus meningitis in a young T-ALL patient and emphasize the importance of considering rare pathogens in the differential diagnosis of meningitis in immunocompromised individuals. The case underscores the significance of early identification and appropriate antifungal treatment.

Results

Fungal culture revealed pale pink, smooth, mucoid colonies on Sabouraud dextrose agar identified as C. albidus by VITEK 2. The organism was susceptible to amphotericin B and flucytosine. Treatment with intravenous liposomal amphotericin B and flucytosine for 15 days resulted in clinical improvement with resolution of headache and vomiting. Procalcitonin levels decreased from 65 to 0.32 ng/ml after treatment.

Conclusion

This case demonstrates the importance of early identification and appropriate antifungal therapy in C. albidus meningitis, particularly in immunocompromised patients with T-ALL. Elevated procalcitonin levels suggest a potential biomarker role in fungal infections. Enhanced awareness of rare pathogens and further research into C. albidus epidemiology and optimal treatment strategies are needed.
  • Published in:Access Microbiology,
  • Study Type:Case Report,
  • Source: PMID: 41104066, DOI: 10.1099/acmi.0.000920.v4
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