Combined Cryptococcal and Bacterial Meningitis in an Immunocompetent 15-Year-Old: A Case Report.

Introduction: Cryptococcal meningitis is a serious fungal infection of the meninges, typically seen in immunosuppressed patients. The occurrence of cryptococcal meningitis in immunocompetent individuals is very rare. Coinfection with bacterial meningitis is even more unusual. Primary Diagnoses Interventions and Outcomes: We report the case of a 15-year-old male who presented to a district hospital in rural Western Uganda with a 2-week history of severe headache, altered mentation, vomiting, and high-grade fever unresponsive to initial empirical treatment for cryptococcal meningitis. Subsequent evaluation revealed a combined fungal and bacterial meningeal infection. Tailored antifungal and antibacterial therapy led to significant clinical improvement, though residual neurological sequelae persisted at discharge. Conclusion: This case highlights the diagnostic and therapeutic challenges in low-resource settings. High clinical vigilance, even for those with no comorbidities or immunosuppression, and the use of easily available diagnostic modalities can help with early diagnosis and better outcomes.