Cryptococcus albidus fungemia and meningitis in very preterm newborn: case report and review of the literature

Abstract

Abstract Background: In the pediatric and neonatal age groups, infections from non-neoformans Cryptococcusspecies, notably Cryptococcus albidus, are rarely observed and isolated. C. albidus is an emerging fungal infection that causes severe diseases in immunosuppressed patients; furthermore, it has rarely been reported to cause diseases in immunocompetent patients. Several cases have been described in adults who were severely immunosuppressed. Importantly, the clinical syndromes in these reported cases encompass fungemia, meningitis, keratitis, and pulmonary and cutaneous infections. Individuals at risk include neutropenic patients, those with indwelling intravenous devices, those on prolonged steroid or antibiotic use, and those with impaired immune systems and prematurity. The susceptibility of preterm infants with low birth weight to infections, particularly fungal ones, remains a significant concern. This report presents a rare case of fungemia and meningitis due to Cryptococcus albidus in a preterm neonate, emphasizing the clinical significance and potential implications for future treatment and management.. This report aims to alert physicians of the rarity of C. albidus infections in pediatric patients and to review the clinical significance, pathology, treatment, and outcomes. Case Presentation: We report the first case of C. albidus fungemia and meningitis in low-birth-weight preterm infants. Notably, the patient was admitted for lifesaving treatment from the Alleith Hospital due to prematurity. The blood culture grew C. albidus, which was sensitive to liposomal agents. The patient showed improvement following a six-week treatment regimen with liposomal amphotericin B at a dosage of 5 mg/kg body weight, notably without the inclusion of 5-fluorocytosine, and experienced no sequelae. Conclusions: This case report underscores the importance of early diagnosis and appropriate antifungal treatment for managing rare fungal infections in vulnerable populations, such as preterm infants. Moreover, it highlights the need for improved diagnostic platforms and comprehensive management protocols for uncommon pathogens in neonatal settings.