Post-infectious inflammatory response syndrome in an HIV-negative patient after Cryptococcus gattii meningoencephalitis: a case report and review of the literature

Abstract

Background Cryptococcal meningitis (CM) is an inflammatory mycosis of the central nervous system caused by meninge infection or brain parenchyma with Cryptococcus species. It is associated with high morbidity and mortality, and patients with acquired immune deficiency syndrome are particularly susceptible. There have been increasing reports of CM in HIV-negative patients in China over the last few years. Case presentation A 31-year-old healthy Chinese male presented with fever and gradually developed headache, projectile vomiting, and other manifestations that were later confirmed as Cryptococcus gattii meningoencephalitis. However, multiple disease changes occurred during the course of treatment, and the regimen was accordingly modified after the diagnosis of post-infectious inflammatory response syndrome (PIIRS). The patient eventually recovered. Conclusion There has been a growing trend in the incidence of C. gattii meningoencephalitis in HIV-negative patients. It shows rapid onset and severe prognosis. This case report can provide a reference to treat PIIRS following CM in HIV-negative patients.

Case report: Experience and insights on the treatment of two cases of cryptococcal meningitis during the later stages of the COVID-19 pandemic

“…The presence of capsules significantly increases the diameter of Cryptococcus spores and enhances their pathogenicity. Initial infection of Cryptococcus neoformans occurs via inhalation of infectious propagules and subsequent colonization of the respiratory tract ( 6 ).When the immune system is compromised, the primary infection occurs in the lungs, then it disseminates and invades the central nervous system, resulting in CM as the most significant and commonly affected location ( 7 , 8 ). Furthermore, there are pulmonary cryptococcosis.…”