Neurosyphilis with concomitant cryptococcal meningitis in a patient with AIDS after COVID-19: a case report

BACKGROUND: The common infection agents causing meningitis in patients with human immunodeficiency virus (HIV) include Cryptococcus neoformans and Treponema pallidum. Furthermore, there is an elevated risk of meningitis in patients with HIV concomitantly infected with SARS-CoV-2. CASE PRESENTATION: A 38-year-old male presented with headache and dizziness. After hospitalization, polymerase chain reaction test for SARS-CoV-2 with a nasopharyngeal swab was positive, and lumbar puncture revealed neurosyphilis with concomitant cryptococcal meningitis. He underwent nirmatrelvir-ritonavir, penicillin, antifungal and antiretroviral treatment. The patient had no other neurological symptoms and was stable during the 6-month follow-up period. CONCLUSIONS: During the COVID-19 pandemic patients with HIV, particularly those who did not undergo antiretroviral therapy are at higher risk for severe infections, including central nervous system complications, due to their compromised immune systems.