Lethal otogenic Candida meningitis

History revealed a chronic obstructive pulmonary condition which had been treated with prednisolone for a long time. There was a raised temperature with further signs of an acute inflammatory underlying disease and internal hydrocephalus. After performing trepanation, the symptoms of raised intercerebral pressure ceased. Candida albicans could be detected microbiologically in the cerebrospinal fluid. There was no pneumonia at the time of admission. Despite instituting immediate intensive care with administration of antibiotics and antimycotics, the patient died 11 days after inpatient admission. Autopsy revealed a C. albicans mycosis originating from the right middle ear with extensive suppurative meningitis, which was the immediate cause of death. Confluent bronchopneumonia had developed in both lower lung lobes at the time of death, but did not show any signs of mycosis and had contributed indirectly to the death of the patient.