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Combined Cryptococcal and Bacterial Meningitis in an Immunocompetent 15-Year-Old: A Case Report

Martha Ann Mbonye1, Edna Joyce Nagaddya1

  • 1Internal Medicine Department, Kagando Hospital, Kasese, Uganda.

Case Reports in Infectious Diseases
|May 27, 2026
PubMed
Abstract

Insights

This case study reports a rare instance of combined fungal and bacterial meningitis in an immunocompetent adolescent in rural Uganda. Early diagnosis and tailored treatment were crucial for improvement, despite residual neurological effects.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Mycology

Background:

  • Cryptococcal meningitis is a severe fungal infection primarily affecting immunocompromised individuals.
  • Coinfection with bacterial meningitis is exceptionally rare, particularly in immunocompetent hosts.
  • This case occurred in a resource-limited setting in rural Western Uganda.

Purpose of the Study:

  • To report a rare case of concurrent cryptococcal and bacterial meningitis in an immunocompetent adolescent.
  • To highlight the diagnostic and therapeutic challenges in low-resource settings for complex meningitis cases.
  • To emphasize the importance of clinical vigilance for unusual presentations.

Main Methods:

  • Case report of a 15-year-old male presenting with symptoms suggestive of meningitis.
  • Initial empirical treatment for cryptococcal meningitis was ineffective.
  • Subsequent diagnostic evaluation identified a coexisting bacterial infection, leading to tailored antifungal and antibacterial therapy.

Main Results:

  • The patient presented with severe headache, altered mentation, vomiting, and fever unresponsive to initial treatment.
  • Combined fungal (Cryptococcus) and bacterial meningitis was diagnosed.
  • Tailored antimicrobial therapy resulted in significant clinical improvement.
  • Residual neurological deficits were noted at discharge.

Conclusions:

  • Combined fungal and bacterial meningitis is an unusual but serious condition that can occur even in immunocompetent individuals.
  • Effective management requires prompt diagnosis and appropriate, targeted therapy.
  • Clinical vigilance and the judicious use of available diagnostic tools are essential for improving outcomes in resource-limited settings.
Keywords:
bacterial meningitiscoinfectioncryptococcal meningitisimmunocompetent hostlow-resource settingsneurologytropical medicine

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