Co-Infection of Cryptococcal and Multidrug Resistant Tuberculous Meningitis in Immunocompetent Patient

A rare, previously unreported case of concurrent central nervous system infection with Cryptococcus neoformans and multi-drug resistant Mycobacterium tuberculosis in a 27-year-old immunocompetent female patient who reported to a tertiary care centre in North India. Various diagnostic and case management difficulties encountered for the management of this case have been highlighted. Correct and complete etiological identification, enabling early, appropriate treatment in patients with concomitant infections may pose a diagnostic dilemma. The case highlights the need to maintain an increased level of clinical suspicion for co-infections with tuberculosis (TB), (especially in TB meningitis), even if there are no obvious signs of immunodeficiency, thereby indicating that TB could be the cause for immunosuppression, hence paving way for opportunistic infections.