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Cryptococcal meningitis in an immunocompetent child: a case report and literature review

Norlijah Othman1, Nor Atiqah Ng Abdullah, Zubaidah Abdul Wahab

  • 1Department of Human Growth and Development, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia. nor@medic.upm.edu.my

The Southeast Asian Journal of Tropical Medicine and Public Health
|May 27, 2005
PubMed

Insights

A child with unexplained fever and headache was diagnosed with Cryptococcus neoformans meningitis. Early diagnosis and treatment are crucial for this rare pediatric fungal infection.

Area of Science:

  • Pediatric Infectious Diseases
  • Mycology
  • Neurology

Background:

  • Fungal meningitis, particularly Cryptococcus neoformans meningitis, is rare in immunocompetent children.
  • Pyrexia of unknown origin (PUO) and headache are non-specific symptoms that can mask serious underlying conditions.

Observation:

  • A 5-year-old immunocompetent girl presented with PUO and headache.
  • Extensive initial investigations, including blood and urine cultures, malaria tests, and chest X-ray, were negative.
  • Lumbar puncture revealed Cryptococcus neoformans, confirmed by India ink and culture.

Findings:

  • The patient was successfully treated with intravenous amphotericin B and oral fluconazole.
  • Immunological work-up showed no underlying defect in cell-mediated immunity.
  • This case highlights the potential for C. neoformans meningitis to present insidiously.

Implications:

  • Cryptococcus neoformans meningitis should be considered in the differential diagnosis of PUO and headache in children, even if immunocompetent.
  • Prompt diagnosis via lumbar puncture is critical for effective management.
  • This case underscores the importance of considering uncommon pathogens in pediatric PUO.

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