Cryptococcal meningitis in an otherwise immunocompetent pregnant woman: a case report

Physiological immunomodulation allows the maternal immune system to maintain tolerance towards the fetus during pregnancy, but may increase maternal susceptibility to infection. This case outlines a rare case of cryptococcal meningitis initially presenting as headache in an otherwise immunocompetent pregnant woman, and highlights the importance of considering atypical infections and local pathogen exposure in pregnancy. 

Headache is a common reason for antenatal review in pregnancy, and migraine and pre-eclampsia were the initial primary differential diagnose prior to LK developing localising infective symptoms. C. gattii is endemic to some tropical and subtropical regions of Australia due to the distribution of host eucalyptus trees, but infection with meningitis and particularly associated cryptococcoma formation is rare. However, this condition carries a high mortality rate of up to 25%, and pregnancy-related immunomodulation may increase vulnerability to such atypical infections.