meningitis in a patient with newly diagnosed acquired immunodeficiency syndrome from Sikkim, India.

Background And Purpose: infections in India have shifted, with an increase in the incidence rate of invasive candidiasis, particularly due to non- species. The central nervous system infections by are sparsely reported and more understanding and research is needed regarding these infections.

Case Report: This study reported an unusual case of meningitis in a middle-aged female with pulmonary tuberculosis and newly diagnosed acquired immunodeficiency syndrome with a low cluster of differentiation 4 count (12 cells/mm). Initially, the patient was treated with fluconazole. Subsequently, the patient underwent therapy involving amphotericin B and flucytosine. The cerebrospinal fluid cultures eventually grew , confirmed by matrix-assisted laser desorption ionization time-of-flight analysis. Despite switching to amphotericin B and flucytosine, the conditions of the patient deteriorated, leading to her death.

Conclusion: candidemia requires meticulous and vigilant management due to its high mortality rate and relatively higher resistance to azoles, particularly fluconazole. This case underscored the severe and pressing challenges in the management of meningitis, particularly in immunocompromised patients.