First case report of fulminant septic shock from meningococcemia associated with Cryptococcus neoformans coinfection in an immunocompetent patient

• Published in: Medical mycology case reports Vol. 26; pp. 44 - 46
• Main Authors: Dienstmann, Guilherme, Avi, Karina Tolfo, Leite, Luiz Arthur Calheiros, Alano, Joaquim Squizatto, Souza, Matheus Leite Ramos de, Mulazani, Marcelo da Silva, Mendivil, Paula Cristina Gern
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01-12-2019; Elsevier
• Subjects: Case Report; Coinfection; Immunocompetent; Meningococcemia; Neurocryptococcosis; Coinfection; Immunocompetent; Meningococcemia; Neurocryptococcosis
• ISSN: 2211-7539; 2211-7539
• DOI: 10.1016/j.mmcr.2019.10.003

The meningococcal disease manifestation associated with the presence of Cryptococcus neoformans is rare. There are no reports in the literature about these simultaneous infections in immunocompetent patients. The aim of the present study is to describe the first case of fulminant septic shock by Neisseira meningitidis associated with Cryptococcus neoformans coinfection in an immunocompetent patient. We describe a case of an immunocompetent 74-year-old Caucasian woman who presented with fulminant acute meningococcemia associated with cryptococcal meningitis, which progressed to worsening general condition and died of septic shock and multiple organ dysfunctions in less than 48 hours. This case report demonstrates the possibility of coinfections related to Neisseria meningitidis and Cryptococcus neoformans, even in immunocompetent patients, which represent a diagnostic challenge for clinicians, thus encouraging further studies for a better understanding.
•Meningococcal infections disseminate early, leading to fulminant disease.•Cryptococcus neoformans meningitis is uncommon in immunocompetent patients.•The association between meningococcal disease and Cryptococcus neoformans infection is very rare and requires a fast diagnosis and management.•The real cause of coinfection between Cryptococcus neoformans and Meningococcal disease in immunocompetent patients remains uncertain.