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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 (T-ALL) developed a brain infection caused by a rare fungus called Cryptococcus albidus. Doctors initially thought he had a viral infection caused by herpes, but tests on his spinal fluid revealed the true fungal culprit. He was treated with antifungal medications that led to his recovery, emphasizing the importance of thorough testing when immunocompromised patients develop serious infections.

Background

Cryptococcus albidus is an emerging fungal pathogen that is rarely reported as a cause of meningitis, particularly in immunocompromised patients such as those with haematological malignancies. T-cell acute lymphoblastic leukaemia (T-ALL) is associated with immunosuppression that predisposes patients to opportunistic infections.

Objective

This case report highlights the diagnostic and therapeutic challenges in managing C. albidus meningitis in a young T-ALL patient, initially suspected to have Herpes Simplex Virus (HSV) encephalitis, and emphasizes the importance of considering rare pathogens in the differential diagnosis of meningitis in immunocompromised populations.

Results

Fungal culture revealed pale pink, smooth, mucoid colonies on Sabouraud dextrose agar identified as C. albidus by VITEK 2. Antifungal susceptibility testing confirmed susceptibility to amphotericin B and flucytosine. Treatment with intravenous liposomal amphotericin B and flucytosine resulted in clinical improvement with resolution of symptoms and normalization of intracranial pressure.

Conclusion

Early identification and appropriate antifungal therapy with liposomal amphotericin B and flucytosine are essential for favorable outcomes in C. albidus meningitis. This case underscores the need for heightened awareness of rare pathogens in meningitis diagnosis, particularly in immunocompromised patients, and calls for further research into the epidemiology and optimal treatment strategies for C. albidus infections.
  • Published in:Access Microbiology,
  • Study Type:Case Report,
  • Source: PMID: 41104066, DOI: 10.1099/acmi.0.000920.v4
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