A rare case report of concurrent cryptococcal, streptococcal, and tuberculous meningitis in a patient with pulmonary tuberculosis
Abstract
RATIONALE: Meningitis caused by concurrent infections with Cryptococcus neoformans, Streptococcus equi subsp. equi, and Mycobacterium tuberculosis is extremely rare.
PATIENT CONCERNS: We present the case of a 63-year-old male patient who presented with headaches, dizziness, nausea, vomiting, and fever for the past 3 weeks.
DIAGNOSES: The patient was diagnosed with concurrent cryptococcal, streptococcal, and tuberculous meningitis.
INTERVENTIONS: The patient received isoniazid, rifampicin, ethambutol, and levofloxacin for 1 month, in addition to liposomal amphotericin B with flucytosine for 2 weeks, followed by fluconazole with flucytosine for additional 2 weeks.
OUTCOMES: The symptoms improved, and outpatient therapy was continued.
LESSONS: Infectious meningitis requires a combination of microscopy, culture, and rapid molecular diagnostics for early diagnosis and treatment.
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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