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Cryptococcus humicolus meningitis: first case report in Malaysia

Siti Roszilawati Ramli1, Mooi Chin Leong, Tzar Mohd Nizam Khaithir

  • 1Department of Medical Microbiology and Immunology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur. srosz77@gmail.com

The Southeast Asian Journal of Tropical Medicine and Public Health
|February 26, 2013
PubMed

Insights

This case study details Cryptococcus humicolus meningitis in an immunocompetent patient, complicated by hydrocephalus. Treatment showed improvement, but the patient succumbed to a secondary Staphylococcus aureus infection.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Mycology

Background:

  • Cryptococcus humicolus meningitis is a rare fungal infection.
  • Communicating hydrocephalus can be a complication of meningitis.
  • Immunocompetent individuals can be susceptible to opportunistic fungal infections.

Observation:

  • A 49-year-old nursing home resident presented with progressive neurological symptoms including headache, blurred vision, and gait disturbance.
  • The patient had a history of chronic cough and poor oral intake.
  • Cerebrospinal fluid analysis confirmed Cryptococcus humicolus meningitis.

Findings:

  • The patient received intravenous amphotericin B and oral fluconazole, showing clinical and microbiological improvement.
  • Despite initial response to antifungal therapy, the patient developed a nosocomial infection.
  • The patient ultimately died from overwhelming sepsis due to methicillin-resistant Staphylococcus aureus (MRSA) infection.

Implications:

  • This case highlights the potential for Cryptococcus humicolus to cause severe meningitis even in immunocompetent hosts.
  • Effective antifungal treatment can lead to clinical improvement, but complications like hydrocephalus and secondary infections pose significant risks.
  • The case underscores the importance of vigilance for nosocomial infections in hospitalized patients, particularly those with underlying conditions.

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