A case of Cryptococcus laurentii meningitis in an immunocompromised patient: case report

Sangeeta Bhalavi; Pooja Shendre; Da I Nesha Banylla Lyngdoh; Nirmal Channe; Sunanda Shrikhande

doi:10.18203/2320-6012.ijrms20260263

Authors

Sangeeta Bhalavi Department of Microbiology, GMC Nagpur, Nagpur, Maharashtra, India
Pooja Shendre Department of Microbiology, AIIMS Nagpur, Nagpur, Maharashtra, India
Da I Nesha Banylla Lyngdoh Department of Microbiology, GMC Nagpur, Nagpur, Maharashtra, India
Nirmal Channe Department of Microbiology, GMC Nagpur, Nagpur, Maharashtra, India
Sunanda Shrikhande Department of Microbiology, GMC Nagpur, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20260263

Keywords:

C. laurentii, Cryptococcosis, Immunocompromised

Abstract

Cryptococcosis is an important opportunistic fungal infection among immunocompromised, AIDS patients and those under immunosuppressive therapy. While C. neoformans and C. gattii are the most common pathogens attributed to cryptococcosis, C. laurentii infections are also on the rise. Here, we report a case of meningitis caused by C. laurentii in an HIV infected, male patient with a low CD4+ T cell count. C. laurentii, though rare, has been reported as an etiological agent of cutaneous, pulmonary, disseminated and ocular infections in AIDS as well as HIV negative individuals. Species differentiation is necessary as C. laurentii has been reported to have higher resistance to azoles and flucytosine. Infections caused by Cryptococcus non-neoformans infection are rare and require extensive investigation to be substantiated. Increasing reports of infection caused by other cryptococcal species, can be attributed to the growing number of immunocompromised and debilitated patients with predisposing factors, improvements in their detection and identification, and enhanced awareness of such non-typical infections.

Metrics

Metrics Loading ...

References

Molina-Leyva A, Ruiz-Carrascosa JC, Leyva-Garcia A, Husein-Elahmeda H. Cutaneous Cryptococcus laurentii infection in an immunocompetent child. Int J Infect Dis. 2013;17(12):e1232-3.

Miceli MH, Díaz JA, Lee SA. Emerging opportunistic yeast infections. Lancet Infect Dis. 2011;11:142-51. DOI: https://doi.org/10.1016/S1473-3099(10)70218-8

Cano EJ, Yetmar ZA, Razonable RR. Cryptococcus Species Other Than Cryptococcus neoformans and Cryptococcus gattii: Are They Clinically Significant? Open Forum Infect Dis. 2020;7(12):ofaa527. DOI: https://doi.org/10.1093/ofid/ofaa527

McCurdy LH, Morrow JD. Infections due to non-neoformans cryptococcal species. Compr Ther. 2003;29:95-101. DOI: https://doi.org/10.1007/s12019-003-0012-9

Islam N, Bharali R, Talukdar S, Hussain SA, Akand AH, Sarma HK. Occurrence and Distribution of Cryptococcus Species in Environmental Sources from Lower Assam Belt of India. J Pure Appl Microbiol. 2020;14:2781-800. DOI: https://doi.org/10.22207/JPAM.14.4.54

Molina-Leyva A, Ruiz-Carrascosa JC, Leyva-Garcia A, Husein-Elahmeda H. Cutaneous Cryptococcus laurentii infection in an immunocompetent child. Int J Infect Dis. 2013;17(12):e1232-3. DOI: https://doi.org/10.1016/j.ijid.2013.04.017

Khawcharoenporn T, Apisarnthanarak A, Mundy LM. Non-neoformans cryptococcal infections: a systematic review. Infection. 2007;35:51-8. DOI: https://doi.org/10.1007/s15010-007-6142-8

Vlchkova-Lashkoska M, Kamberova S, Starova A, Goleva-Mishevska L, Tsatsa- Biljanovska N, Janevska V, et al. Cutaneous Cryptococcus laurentii infection in a human immunodeficiency virus-negative subject. J Eur Acad Dermatol Venereol. 2004;18:99-100. DOI: https://doi.org/10.1111/j.1468-3083.2004.00434.x

Kordossis T, Avlami A, Velegraki A, Stefanou I, Georgakopoulos G, Papalambrou C, et al. First report of Cryptococcus laurentii meningitis and a fatal case of Cryptococcus albidus cryptococcaemia in AIDS patients. Med Mycol. 1998;36(5):335-9. DOI: https://doi.org/10.1046/j.1365-280X.1998.00166.x

Zulfiqar R, Khalid AN. A novel saxicolous species of Circinaria (Megasporaceae, Ascomycota) from Pakistan. Plant Systematics Evolution. 2023;309(3):21. DOI: https://doi.org/10.1007/s00606-023-01856-0

Mittal N, Vatsa S, Minz AK. Fatal meningitis by Cryptococcus laurentii in a post-partum woman: a manifestation of immune reconstitution inflammatory syndrome. Indian J Med Microbiol. 2015;33(4):590-3. DOI: https://doi.org/10.4103/0255-0857.167337

Jarvis JN, Meintjes G, Bicanic T. Cerebrospinal fluid cytokine profiles predict risk of early mortality and immune reconstitution inflammatory syndrome in HIV-associated cryptococcal meningitis. PLoS Pathog. 2015;11:e1004754. DOI: https://doi.org/10.1371/journal.ppat.1004754

Tugume L, Rhein J, Hullsiek KH, Mpoza E, Kiggundu R, Ssebambulidde K, et al. HIV-Associated Cryptococcal Meningitis Occurring at Relatively Higher CD4 Counts. J Infect Dis. 2019;219(6):877-83. DOI: https://doi.org/10.1093/infdis/jiy602

Mondon P, Petter R, Amal.tano G. Heteroresistance to Fluconazole and voriconazole in Cryptococcus neoformans. Antimicrob Agents Chemother. 1999;43:1856-61. DOI: https://doi.org/10.1128/AAC.43.8.1856

Johnson LB, Bradley SF, Kauffman CA. Fungaemia due to Cryptococcus laurentii and a review of on-neoformans cryptococcaemia. Mycoses. 1998;41:277-80. DOI: https://doi.org/10.1111/j.1439-0507.1998.tb00338.x