Abstract
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.