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Co-Infection of Pulmonary Aspergillosis and Cryptococcal Meningitis in an HIV-Positive Patient: A Case Report

Summary

This case describes a man with undiagnosed HIV who developed two serious fungal infections at the same time: a lung infection caused by Aspergillus fungus and a brain infection caused by Cryptococcus fungus. His extremely low immune system (CD4 count of 41) made him vulnerable to multiple opportunistic infections. Despite treatment with antifungal medications, his condition worsened and he passed away, highlighting the dangers of late HIV diagnosis.

Background

Opportunistic fungal infections are common in HIV-positive patients, especially those with delayed diagnosis and low CD4 counts. While cryptococcosis and aspergillosis individually represent serious complications in advanced HIV/AIDS, co-infections of these fungi are rarely reported.

Objective

To present a clinical case of simultaneous pulmonary aspergillosis and cryptococcal meningitis in a late-diagnosed HIV patient with severe immunosuppression (CD4 count of 41 cells/μL).

Results

A 46-year-old HIV-positive male presented with cavitary lung lesion initially suspected to be tuberculosis or hydatid cyst. Lung tissue biopsy confirmed Aspergillus fumigatus infection, identified by histopathology and Aspergillus-specific PCR. One month after treatment initiation, the patient developed cryptococcal meningitis caused by Cryptococcus neoformans (Serotype A, molecular type VNI, sequence type ST69). The patient died 24 hours after diagnosis of cryptococcal meningitis.

Conclusion

This case highlights the vulnerability of severely immunocompromised HIV patients to multiple concurrent fungal infections and emphasizes the importance of considering co-infections in patients with atypical presentations or inadequate treatment response. Early diagnosis, appropriate antifungal therapy, and access to cryptococcal antigen screening are critical for improving outcomes in advanced HIV disease.
  • Published in:Case Reports in Infectious Diseases,
  • Study Type:Case Report,
  • Source: PMID: 40801018, DOI: 10.1155/crdi/5630156
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