Severe brain co-infection by Cryptococcus neoformans and Mycobacterium tuberculosis in a patient with non-bacillary lung tuberculosis

Abstract

An exceptionally rare case of concurrent central nervous system infection by Cryptococcus neoformans and Mycobacteriumtuberculosis in a 25-year-old otherwise healthy Chinese student who very recently joined Italian post-doctoral courses is described, togetherwith diagnostic and therapeutic difficulties encountered in a six-month-long hospitalization period, when only transient and/or negligibleimmune system impairments were detected. A non-bacillary pulmonary tuberculosis probably preceded both brain complications.This episode of very infrequent concurrent infections, should enforce the need of maintaining an elevated clinical suspicion for opportunisticinfections and tuberculosis, even in absence of an obvious immunodeficiency, and related epidemiological clues.