The First of Us? Papiliotrema laurentii Meningitis Complicated by Hydrocephalus in an Otherwise Immunocompetent Host: A Case Report

Cryptococcal species are the most common fungal pathogens to cause meningitis worldwide. The majority of cases are caused by Cryptococcus neoformans and occur in immunocompromised hosts, while Cryptococcus gattii causes most fungal meningitis in immunocompetent hosts. To date, non-neoformans, non-gattii species of Cryptococcus remain rare causes of human disease, and their clinical courses and preferred treatment regimens remain poorly characterized. We present the case of an otherwise immunocompetent woman with subacute meningoencephalitis diagnosed with Papiliotrema laurentii (formerly Cryptococcus laurentii) meningitis, who, despite successful fungal eradication, developed hydrocephalus. To our knowledge, this represents the first case of P. laurentii meningitis in an immunocompetent host leading to hydrocephalus, illustrating the diagnostic and therapeutic challenges that remain for atypical fungal meningitis.