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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 leukemia developed meningitis caused by a rare fungus called Cryptococcus albidus. Doctors initially thought he had a viral infection and started him on antiviral medication, but specialized fungal tests revealed the true culprit. Treatment with antifungal medications successfully cured the infection, demonstrating the importance of identifying the exact cause of infection to provide the right treatment.

Background

Cryptococcus albidus is an emerging fungal pathogen that is uncommon as a cause of meningitis, especially in immunocompromised patients. This case presents a rare infection in a young patient with T-cell acute lymphoblastic leukaemia (T-ALL), which predisposes to opportunistic infections due to immunosuppression.

Objective

This case report documents the clinical presentation, diagnostic challenges, and management of C. albidus meningitis in a T-ALL patient, initially suspected to be HSV encephalitis. The objective is to highlight the importance of considering rare pathogens in meningitis diagnosis and to explore potential biomarkers like procalcitonin in fungal infections.

Results

CSF fungal culture revealed C. albidus on day 4 of incubation on Sabouraud dextrose agar, identified 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 symptoms and normalization of procalcitonin levels from 65 to 0.32 ng/ml.

Conclusion

This case underscores the importance of early identification and appropriate antifungal therapy in C. albidus meningitis. Elevated procalcitonin levels in fungal infections warrant further investigation. Heightened awareness of rare fungal pathogens is essential in immunocompromised patients presenting with meningitis.
  • Published in:Access Microbiology,
  • Study Type:Case Report,
  • Source: PMID: 41104066, DOI: 10.1099/acmi.0.000920.v4
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