Citation Information :
Payal P, Sekar U, Sujatha S, Kindo AJ. Meningitis caused by Cryptococcus neoformans and Herpes simplex virus: Dual infection in an immunocompetent patient. 2016; 18 (2):114-116.
Cryptococcus neoformans and Herpes simplex virus (HSV) are known agents of fungal and viral meningitis, respectively, in immunocompromised patients but rarely seen in immunocompetent patients. The present report is of an immunocompetent patient, engineer by profession, who was diagnosed to have meningitis with two organisms. The patient presented with fever, chills and headache for 25 days, altered sensorium for four days and altered speech for two days. Lumbar puncture was done, cerebrospinal fluid was sent for serology and culture was positive for budding yeast cells with capsule in India ink preparation. Culture yielded mucoid, cream-coloured colonies, and latex agglutination for Cryptococcus antigen was positive. Polymerase chain reaction on CSF was positive for HSV-1. The patient was treated with Ceftriaxone, Doxycycline, Acyclovir, injection Mannitol and Amphotericin B.
Casadevall A, Perfect JR. Cryptococcus neoformans. Vol. 595. Washington, DC: ASM Press; 1998.
Holmes CB, Losina E, Walensky RP, Yazdanpanah Y, Freedberg KA. Review of human immunodeficiency virus type 1-related opportunistic infections in Sub-Saharan Africa. Clin Infect Dis 2003;36:652-62.
Chariyalertsak S, Sirisanthana T, Saengwonloey O, Nelson KE. Clinical presentation and risk behaviors of patients with acquired immunodeficiency syndrome in Thailand, 1994-1998: Regional variation and temporal trends. Clin Infect Dis 2001;32:955-62.
Chau TT, Mai NH, Phu NH, Nghia HD, Chuong LV, Sinh DX, et al. A prospective descriptive study of cryptococcal meningitis in HIV uninfected patients in Vietnam - High prevalence of Cryptococcus neoformans var grubii in the absence of underlying disease. BMC Infect Dis 2010;10:199.
Pandit L, Agrawal A, Shenoy S, Kamath G. Cryptococcal meningitis and pulmonary cryptococossis in a non-HIV infected patient. Eur J Gen Med 2006;3:80-2.
Viviani MA, Tortorano AM, Ajello L. Cryptococcus. In: Anaissie EJ, McGinnis MR, Pfaller MA, editors. Clinical Mycology. 1 st ed. USA: Elsevier Science; 2003. p. 240-559.
Madan M, Ranjitham M, Chandrasekharan S. Cryptococcal meningitis in immunocompetent individuals. J Assoc Physicians India 1999;47:933-4.
Prasad KN, Agarwal J, Nag VL, Verma AK, Dixit AK, Ayyagari A. Cryptococcal infection in patients with clinically diagnosed meningitis in a tertiary care center. Neurol India 2003;51:364-6.
Momméja-Marin H, Lafaurie M, Scieux C, Galicier L, Oksenhendler E, Molina JM. Herpes simplex virus type 2 as a cause of severe meningitis in immunocompromised adults. Clin Infect Dis 2003;37:1527-33.
Datta K, Jain N, Sethi S, Rattan A, Casadevall A, Banerjee U. Fluconazole and itraconazole susceptibility of clinical isolates of Cryptococcus neoformans at a tertiary care centre in India: A need for care. J Antimicrob Chemother 2003;52:683-6.
