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

Abstract Background In pediatric and neonatal age groups, infections from non-neoformans Cryptococcus species, notably Cryptococcus albidus, are rarely encountered. C. albidus is an emerging fungal pathogen that causes severe diseases in immunosuppressed patients; furthermore, it has rarely been rep...

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Main Authors: Sameera Mohmmed Aljehani, Tasneem Ibraheem A. Zaidan, Noora Obaid AlHarbi, Shurooq Alharbi
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Pediatrics
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Online Access:https://doi.org/10.1186/s12887-025-05614-8
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author Sameera Mohmmed Aljehani
Tasneem Ibraheem A. Zaidan
Noora Obaid AlHarbi
Shurooq Alharbi
author_facet Sameera Mohmmed Aljehani
Tasneem Ibraheem A. Zaidan
Noora Obaid AlHarbi
Shurooq Alharbi
author_sort Sameera Mohmmed Aljehani
collection DOAJ
description Abstract Background In pediatric and neonatal age groups, infections from non-neoformans Cryptococcus species, notably Cryptococcus albidus, are rarely encountered. C. albidus is an emerging fungal pathogen 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 symptoms in these reported cases include fungemia, meningitis, keratitis, 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 C. 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 a very low-birth-weight, preterm infant of 31 weeks. Notably, the patient was admitted for lifesaving treatment from the Alleith Hospital due to prematurity. The patient received surfactant due to ARDS, TPN, and fluconazole prophylaxis. On day 11, features of sepsis were observed and the blood culture grew C. albidus, which was sensitive to liposomal agents. CSF evaluation suggested meningitis. The patient improved following a six-week treatment regimen with liposomal formulations of amphotericin B at a dosage of 5 mg/kg body weight once daily, notably administered without 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 rare pathogens in neonatal settings.
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spelling doaj-art-ac514ec937334a7aa375b79d7574c0162025-08-20T02:25:41ZengBMCBMC Pediatrics1471-24312025-04-012511510.1186/s12887-025-05614-8Cryptococcus albidus fungemia and probable meningitis in very preterm newborn: a case report and review of the literatureSameera Mohmmed Aljehani0Tasneem Ibraheem A. Zaidan1Noora Obaid AlHarbi2Shurooq Alharbi3Department of Pediatric-Infectious Diseases, King Abdulaziz HospitalDepartment of Pediatric-Infectious Diseases, King Abdulaziz HospitalDepartment of Pediatric-Infectious Diseases, King Abdulaziz HospitalDepartment of Pediatric-Infectious Diseases, King Abdulaziz HospitalAbstract Background In pediatric and neonatal age groups, infections from non-neoformans Cryptococcus species, notably Cryptococcus albidus, are rarely encountered. C. albidus is an emerging fungal pathogen 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 symptoms in these reported cases include fungemia, meningitis, keratitis, 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 C. 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 a very low-birth-weight, preterm infant of 31 weeks. Notably, the patient was admitted for lifesaving treatment from the Alleith Hospital due to prematurity. The patient received surfactant due to ARDS, TPN, and fluconazole prophylaxis. On day 11, features of sepsis were observed and the blood culture grew C. albidus, which was sensitive to liposomal agents. CSF evaluation suggested meningitis. The patient improved following a six-week treatment regimen with liposomal formulations of amphotericin B at a dosage of 5 mg/kg body weight once daily, notably administered without 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 rare pathogens in neonatal settings.https://doi.org/10.1186/s12887-025-05614-8Case reportCryptococcus albidusPrematureFungemiaLiposomal amphoterici
spellingShingle Sameera Mohmmed Aljehani
Tasneem Ibraheem A. Zaidan
Noora Obaid AlHarbi
Shurooq Alharbi
Cryptococcus albidus fungemia and probable meningitis in very preterm newborn: a case report and review of the literature
BMC Pediatrics
Case report
Cryptococcus albidus
Premature
Fungemia
Liposomal amphoterici
title Cryptococcus albidus fungemia and probable meningitis in very preterm newborn: a case report and review of the literature
title_full Cryptococcus albidus fungemia and probable meningitis in very preterm newborn: a case report and review of the literature
title_fullStr Cryptococcus albidus fungemia and probable meningitis in very preterm newborn: a case report and review of the literature
title_full_unstemmed Cryptococcus albidus fungemia and probable meningitis in very preterm newborn: a case report and review of the literature
title_short Cryptococcus albidus fungemia and probable meningitis in very preterm newborn: a case report and review of the literature
title_sort cryptococcus albidus fungemia and probable meningitis in very preterm newborn a case report and review of the literature
topic Case report
Cryptococcus albidus
Premature
Fungemia
Liposomal amphoterici
url https://doi.org/10.1186/s12887-025-05614-8
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