Cryptococcus albidus meningitis: A case report and literature review

Rationale:Central nervous system (CNS) infections caused by Cryptococcus albidus are rarely reported, but are often associated with high mortality rates. Clinical data on the appropriate use of liposomal-amphotericin B (liposomal-AmB) with cryptococcal meningitis are limited. Here, we report for the first time the efficacious and safe use of the ideal bodyweight to calculate the dose of liposomal-AmB for a severely obese patient with C albidus meningitis. We also review the cases of CNS infection caused by C albidus and its related species.Patient concerns:A severely obese female patient was admitted to neurosurgical ward with lesions in the intracranial space and accompanying headache. Brain magnetic resonance imaging revealed prominent lesions in the right parietal and left frontal insular region. After glioma resection, C albidus was isolated from her cerebrospinal fluid samples.Diagnoses, interventions, and outcomes:She diagnosed histopathologically with a Cryptococcus species infection. The culture from her cerebrospinal fluid sample showed the growth of yeast-like colonies, which were identified as C albidus with mass spectrometry. She was treated with liposomal-AmB (50 mg day-1 intravenously) plus 5-fluorocytosine (10 g day-1 orally in 4 divided doses) for 6 weeks. The patient was asymptomatic at the time of discharge.Lessons:CNS infections of C albidus were uncommon. Using ideal bodyweight to calculate the dose of liposomal-AmB should be considered for severely obese patients with C albidus meningitis.