Kulkarni Mrunalini, Sawant Unmesh R, Kakarla Nidhisha
Pediatrics and Neonatology, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli, IND.
Pediatrics and Child Health, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli, IND.
Cureus. 2025 Apr 14;17(4):e82271. doi: 10.7759/cureus.82271. eCollection 2025 Apr.
Cryptococcal meningoencephalitis is a grave and lethal form of an opportunistic infection usually occurring in immunocompromised patients (i.e., those with AIDS, organ transplant recipients, or those on immunosuppressive therapy) caused by species, namely which has a worldwide distribution, or which is predominantly found in tropical, subtropical, and temperate regions. species are usually found in soil contaminated with bird or animal droppings in the form of cryptococcal spores. The former occurs predominantly in immunocompromised patients, affecting the central nervous system (CNS), while the latter occurs in immunocompetent patients, affecting the pulmonary system predominantly. Transmission occurs through these spores, which subsequently disseminate to the CNS through the hematogenous route. Manifestations include fever, headache, nausea, altered mental status, and meningismus in certain cases, potentially advancing to neurological problems such as elevated intracranial pressure, blindness, and seizures. Presentation in immunocompetent individuals is indolent, so diagnosis and treatment are delayed. Timely diagnosis and immediate treatment are essential to avert complications and mortality. Over the past few years, cryptococcal infection has seen an upward trend globally. Despite the availability of antifungal therapy, it has emerged as a significant public health concern, rendering it a therapeutically challenging case. Moreover, infrequent coinfections with bacteria or viruses might complicate therapy and prognosis. We hereby report a rare case of cryptococcal meningoencephalitis with herpes zoster coinfection occurring in an HIV patient with a normal CD4 count.
隐球菌性脑膜脑炎是一种严重且致命的机会性感染，通常发生在免疫功能低下的患者（即艾滋病患者、器官移植受者或接受免疫抑制治疗的患者）中，由新型隐球菌引起，该菌在全球范围内均有分布，或格特隐球菌，主要见于热带、亚热带和温带地区。新型隐球菌通常以隐球菌孢子的形式存在于被鸟类或动物粪便污染的土壤中。前者主要发生在免疫功能低下的患者中，影响中枢神经系统（CNS），而后者发生在免疫功能正常的患者中，主要影响肺部系统。传播通过这些孢子发生，随后通过血行途径扩散到中枢神经系统。表现包括发热、头痛、恶心、精神状态改变，在某些情况下还会出现颈项强直，可能进展为颅内压升高、失明和癫痫等神经问题。免疫功能正常个体的表现较为隐匿，因此诊断和治疗会延迟。及时诊断和立即治疗对于避免并发症和死亡至关重要。在过去几年中，隐球菌感染在全球呈上升趋势。尽管有抗真菌治疗方法，但它已成为一个重大的公共卫生问题，使其成为一个治疗上具有挑战性的病例。此外，与细菌或病毒的罕见合并感染可能会使治疗和预后复杂化。我们在此报告一例罕见的隐球菌性脑膜脑炎合并带状疱疹感染的病例，该病例发生在一名CD4计数正常的HIV患者身上。
