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Cryptococcal meningitis with malaria. A case report
1Department of Pathology & Microbiology, Faculty of Medical Sciences, University of West Indies, Trinidad.
Abstract:
Cryptococcal meningitis is an uncommon infection globally, including Nigeria. This systemic fungal infection often is associated with immunodeficiency. The most common causes of meningitis in Nigeria in the 2-3 year age group are the malaria parasites and bacteria. The concomitant infections of Cryptococcal neoformans and Plasmodium falciparum are uncommon. We present here the report of a case of fatal cryptococcal meningitis with malaria infection in a 2 year old child from Nigeria (one of the malaria endemic regions of the world). This case emphasizes the importance of doing a combination of fungal and bacterial cultures as well as looking for malarial parasites in the determination of etiological agents of meningitis in any hospital in Africa. We suggest that cerebrospinal fluid from meningitis cases must be cultured using Sabouraud dextrose agar and any growth on the agar must be examined using Indian ink.
Insights
Fatal cryptococcal meningitis with malaria coinfection is rare in Nigerian children. This case highlights the need for combined fungal, bacterial, and malaria testing in meningitis diagnosis across Africa.
Area of Science:
- Mycology
- Infectious Diseases
- Pediatrics
Background:
- Cryptococcal meningitis, a systemic fungal infection, is uncommon globally and often linked to immunodeficiency.
- In Nigeria, common meningitis causes in young children include malaria parasites and bacteria.
- Concomitant infections with Cryptococcus neoformans and Plasmodium falciparum are infrequent.
Observation:
- A fatal case of cryptococcal meningitis co-occurring with malaria infection in a 2-year-old child from Nigeria is reported.
- The patient was from a malaria-endemic region, underscoring the potential for coinfections.
Findings:
- The case demonstrates a rare coinfection of fungal meningitis and malaria in a pediatric patient.
- Diagnostic challenges in differentiating or identifying coinfecting pathogens are implied.
Implications:
- Emphasizes the critical need for combined fungal, bacterial, and malaria parasite testing in meningitis cases in African hospitals.
- Recommends culturing cerebrospinal fluid with Sabouraud dextrose agar and examining growth with Indian ink for accurate etiological determination.