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

Guilherme Dienstmann; Karina Tolfo Avi; Luiz Arthur Calheiros Leite; Joaquim Squizatto Alano; Matheus Leite Ramos de Souza; Marcelo da Silva Mulazani; Paula Cristina Gern Mendivil

doi:10.1016/j.mmcr.2019.10.003

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

Med Mycol Case Rep. 2019 Oct 3:26:44-46. doi: 10.1016/j.mmcr.2019.10.003. eCollection 2019 Dec.

Authors

Guilherme Dienstmann¹, Karina Tolfo Avi², Luiz Arthur Calheiros Leite³, Joaquim Squizatto Alano⁴, Matheus Leite Ramos de Souza⁵, Marcelo da Silva Mulazani⁶, Paula Cristina Gern Mendivil⁶

Affiliations

¹ Health and Environment Department, University of the Region of Joinville, UNIVILLE, Joinville, SC, Brazil.
² Group Ghanem/DASA, Hans Dieter Schmidt Regional Hospital, Joinville, SC, Brazil.
³ Health Science University of Alagoas State - UNCISAL, Maceió, AL, Brazil.
⁴ Internal Medicine Department, Hans Dieter Schmidt Regional Hospital, Joinville, SC, Brazil.
⁵ Department of Medicine, University of Region of Joinville - UNIVILLE, Joinville, SC, Brazil.
⁶ Infectious Disease Department, Hans Dieter Schmidt Regional Hospital, Joinville, SC, Brazil.

Abstract

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.

Keywords: Coinfection; Immunocompetent; Meningococcemia; Neurocryptococcosis.

Publication types

Case Reports