Cryptococcal and EBV Meningitis in a Postpartum Woman With HIV Despite ART: A Case Challenging the Limits of Immune Reconstitution

Authors

Rouba Isshak, St. Joseph’s University Medical Center, Department of Internal Medicine, Paterson, New Jersey.Follow
Zhaoqi Li, Saint George’s University, School of Medicine, Grenada
Aqsa Zoey Sorathia MD, St.Joseph's University Medical Center, Department of Internal Medicine, Paterson, New Jersey
Opeyemi Fakayode, St. Joseph’s University Medical Center, Department of Internal Medicine, Paterson, New Jersey
Ivan Mercado, St. Joseph’s University Medical Center, Department of Internal Medicine, Paterson, New Jersey
Malina Mohtadi, St. Joseph’s University Medical Center, Department of Internal Medicine, Paterson, New Jersey.
Nader Ghobriel, St. Joseph’s University Medical Center, Department of Internal Medicine, Paterson, New Jersey
Mina Gerges, St. Joseph’s University Medical Center, Department of Internal Medicine, Paterson, New Jersey
Patrick Michael, St. Joseph’s University Medical Center, Department of Internal Medicine, Paterson, New Jersey
Simi Philip, St. Joseph’s University Medical Center, Department of Infectious Diseases, Paterson, New Jersey

Abstract

Cryptococcal meningitis (CM) is a life-threatening opportunistic infection, mainly affecting immunocompromised patients, especially with advanced HIV/AIDS. Unmasking cryptococcal immune reconstitution inflammatory syndrome (C-IRIS) is a severe but relatively rare complication in the United States. Co-infection with other central nervous system (CNS) pathogens further complicates both diagnosis and management.

In this case report, we present a rare instance of CM secondary to C-IRIS alongside EBV meningitis in a postpartum, HIV-positive patient on ART. This co-infection highlights the vulnerability of immunocompromised individuals, even on ART, to multifactorial CNS infections. It emphasizes the need for vigilant monitoring, timely intervention, and comprehensive long-term management in high-risk groups such as postpartum patients, while also highlighting the importance of thorough opportunistic infection screening before ART initiation to reduce the risk of IRIS-related complications.

Recommended Citation

Isshak, Rouba; Li, Zhaoqi; Sorathia, Aqsa Zoey MD; Fakayode, Opeyemi; Mercado, Ivan; Mohtadi, Malina; Ghobriel, Nader; Gerges, Mina; Michael, Patrick; and Philip, Simi (2026) "Cryptococcal and EBV Meningitis in a Postpartum Woman With HIV Despite ART: A Case Challenging the Limits of Immune Reconstitution," Journal of Community Hospital Internal Medicine Perspectives: Vol. 16: Iss. 2, Article 9.
DOI: 10.55729/2000-9666.1577
Available at: https://scholarlycommons.gbmc.org/jchimp/vol16/iss2/9

DOI

10.55729/2000-9666.1577