Recurrence of HIV-associated cryptococcal meningitis in pregnancy and the post-partum period

We report a case of recurrent cryptococcal meningitis in a pregnant woman living with vertically acquired HIV. Despite effective treatment of primary infection prior to pregnancy, she later experienced a microbiological relapse of cryptococcal meningitis during pregnancy, and an immune-reconstitution inflammatory syndrome in the post-partum period. This case emphasises the impact of pregnancy related immunological changes on the natural history of complex infections. This case illustrates the challenges of managing opportunistic infections throughout pregnancy and the influence of perinatal immunological changes on disease course.