At present, there are few studies on co-infection with Influenza A virus and Cryptococcus. This paper reports a case of a patient who developed cryptococcal (Cryptococcus gattii) infection secondary to Influenza A and subsequently suffered from meningoencephalitis, in order to enhance clinical understanding of this disease. The patient, a 58-year-old male, was diagnosed with Influenza A and experienced recurrent dizziness and headache for over a month. Later, he developed fever, episodic bilateral lower limb weakness, and intermittent consciousness disorders. Chest CT, head MRI, and cerebrospinal fluid examination after lumbar puncture were performed and Cryptococcus gattii was detected through the pathogen culture of cerebrospinal fluid. Thus the patient was diagnosed with cryptococcal meningoencephalitis. The patient was treated with liposomal amphotericin B and fluconazole for induction therapy, along with treatment reducing intracranial pressure and resisting bacterial infection. Four weeks later, the patient's consciousness improved, and the protein level of cerebrospinal fluid returned to normal. However, the intracranial pressure remained higher than 400 mmH2O. The patient was then transferred to another hospital for further treatment. Compared to Cryptococcus neoformans, Cryptococcus gattii is more commonly found in individuals with normal immune function. In this case, the patient's immune function was normal, but the influenza virus-induced pneumonia might have increased the risk of cryptococcal infection by altering the microenvironment of the lungs. Besides, Influenza A Virus can exacerbate the severity of Cryptococcus gattii infection through multiple mechanisms. Clinicians need to pay attention to the risk of secondary cryptococcal infection in influenza patients and explore comprehensive treatment strategies that combine antiviral, antifungal, immunomodulatory and prognosis-improving measures.
Key words
Cryptococcus gattii /
Influenza A Virus /
meningoencephalitis
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