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Lethal otogenic Candida meningitis.

S Koch¹, B Rudel, H-J Tietz

¹Institut für Pathologie, Humaine Klinikum Bad Saarow, Akademisches Lehrkrankenhaus der Freien Universität Berlin, Germany. hkbs_pathologie@t-online.de

|October 27, 2004

Summary

A rare Candida albicans fungal infection led to fatal meningitis in an immunocompromised patient. Despite intensive care, the infection spread from the middle ear, causing death.

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Area of Science:

Infectious Diseases
Neurology
Pulmonology

Background:

Patient with chronic obstructive pulmonary disease on long-term prednisolone.
Presented with fever, signs of acute inflammation, and hydrocephalus.

Observation:

Trepanation relieved intracranial pressure symptoms.
Candida albicans identified in cerebrospinal fluid.
No initial pneumonia, but developed bronchopneumonia later.

Findings:

Autopsy confirmed C. albicans mycosis originating from the middle ear.
Suppurative meningitis was the direct cause of death.
Bronchopneumonia contributed indirectly to mortality.

Implications:

Highlights the risk of invasive fungal infections in immunosuppressed patients.
Underscores the importance of considering non-respiratory fungal origins for meningitis.
Emphasizes the critical role of early diagnosis and treatment of invasive candidiasis.

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