Case Report: Rare Community-Acquired Pneumonia with Concurrent Methicillin-Resistant Staphylococcus aureus and Cryptococcus neoformans Infection in an Immunocompetent Young Male.

Cryptococcal pneumonia predominantly occurs in immunocompromised patients, but its incidence among immunocompetent individuals has been increasing in recent years. However, cases of co-infection with Cryptococcus neoformans and community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) in immunocompetent hosts remain exceedingly rare. This study reports on a previously healthy 30-year-old male who presented with 20-days cough and 1-day fever. Through nanopore targeted sequencing (NTS) of bronchoalveolar lavage fluid (BLAF) and traditional microbial culture, he was ultimately diagnosed with a co-infection of C. neoformans and CA-MRSA. The patient showed significant improvement after treatment with oral linezolid (0.6 g twice daily) for 2 weeks and oral fluconazole (400 mg once daily) for 6 months. This case highlights that even immunocompetent individuals can simultaneously contract multiple community-acquired pathogens, while also underscoring the clinical utility of NTS in the early diagnosis of co-infections and detection of resistance genes.