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Malassezia furfur meningitis associated with total parenteral nutrition subdural effusion

Cecilia M Rosales1, Mary Anne Jackson, David Zwick

  • 1Department of Pathology, Truman Medical Center, 2301 Holmes Street, Kansas City, MO 64108, USA.

Pediatric and Developmental Pathology : the Official Journal of the Society for Pediatric Pathology and the Paediatric Pathology Society
|July 17, 2004
PubMed

Insights

This case report details Malassezia furfur meningitis in a premature infant. The infection likely resulted from total parenteral nutrition (TPN) fluid entering the brain via a scalp catheter.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Pediatric Neurology

Background:

  • Malassezia furfur is a rare cause of meningitis, particularly in neonates.
  • Premature infants with significant comorbidities are at increased risk for opportunistic infections.
  • Previous cases of Malassezia furfur meningitis are exceptionally uncommon.

Observation:

  • A very low birth weight infant with chronic lung disease, necrotizing enterocolitis, and intraventricular hemorrhage developed Malassezia furfur meningitis.
  • The meningitis occurred late in the infant's course, following treatment for systemic Malassezia furfur infection.
  • Unlike prior reports, the infection was confined to the leptomeninges.

Findings:

  • The meningitis was associated with the extravasation of total parenteral nutrition (TPN) and intralipid fluid into the subarachnoid space.
  • The likely route of infection was via a peripheral scalp catheter.
  • This suggests a localized route of central nervous system (CNS) infection rather than widespread hematogenous dissemination.

Implications:

  • Highlights the potential for Malassezia furfur to cause localized CNS infections in vulnerable neonates.
  • Underscores the importance of vigilance for fungal meningitis in critically ill premature infants.
  • Suggests careful monitoring of central venous catheters and associated fluid administration in high-risk neonates is crucial.

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