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Cryptococcus neoformans Meningoencephalitis in an Immunocompetent Patient after COVID-19 Infection

Hebah Ghanem1, Geetha Sivasubramanian1

  • 1Division of Infectious Diseases, Department of Internal Medicine, University of California, San Francisco, Fresno, California, USA.

Case Reports in Infectious Diseases
|June 30, 2021
PubMed

Insights

A healthy patient developed severe cryptococcal meningitis after COVID-19 treatment with dexamethasone. This highlights emerging secondary infections, including opportunistic pathogens, post-SARS-CoV-2 infection.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Mycology

Background:

  • Cryptococcus neoformans is an opportunistic fungal pathogen causing disseminated infections in immunocompromised individuals.
  • The COVID-19 pandemic has seen an increase in secondary infections, including bacterial, viral, and fungal pathogens.
  • Corticosteroids like dexamethasone are used to treat severe COVID-19 but can suppress the immune system.

Observation:

  • A previously healthy individual developed severe cryptococcal meningitis one week after SARS-CoV-2 infection treatment with dexamethasone.
  • This case represents a rare instance of opportunistic fungal infection following COVID-19 and its treatment.

Findings:

  • The patient experienced a severe opportunistic fungal infection (cryptococcal meningitis) despite being previously healthy.
  • The temporal association suggests a potential link between SARS-CoV-2 infection, dexamethasone treatment, and the emergence of Cryptococcus neoformans.

Implications:

  • This case underscores the risk of secondary opportunistic infections following COVID-19, particularly in patients treated with immunomodulatory drugs.
  • Further research is needed to understand the impact of SARS-CoV-2 infection and treatments on T-cell function and lymphopenia.
  • Clinicians should maintain a high index of suspicion for opportunistic infections in patients recovering from COVID-19, especially those on corticosteroids.

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