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Mucor cerebral abscess associated with intravenous drug abuse
K M Fong1, E M Seneviratne, J G McCormack
1Mater Misericordiae Adult Hospital, Queensland, Brisbane, Australia.
Abstract:
We report on a case of a 26-year-old intravenous narcotic abuser with a primary cerebral mucormycotic abscess caused by Rhizopus oryzae. He was treated with a combination of intravenous and intraventricular amphotericin B and surgical drainage with a successful outcome. There was no evidence that his infection was acquired by the rhinocerebral route, it seems likely that he injected himself with a contaminated batch of narcotic or amphetamine. Mucormycosis presenting in this way has been described previously but this is only the second such case to survive. Early diagnosis and treatment is essential for a favourable outcome in this condition.
Insights
A 26-year-old intravenous drug user survived a rare brain abscess caused by Rhizopus oryzae. Prompt treatment with amphotericin B and surgery led to a successful outcome for this cerebral mucormycosis case.
Area of Science:
- Mycology
- Infectious Diseases
- Neurosurgery
Background:
- Cerebral mucormycosis is a rare and often fatal fungal infection.
- Intravenous drug abuse is an emerging risk factor for invasive fungal infections.
- Rhizopus oryzae is a common cause of mucormycosis.
Observation:
- A 26-year-old male intravenous drug user presented with a primary cerebral abscess.
- The abscess was caused by Rhizopus oryzae, identified through fungal culture.
- The route of infection was presumed to be direct injection of contaminated substances, not rhinocerebral.
Findings:
- The patient received a combination of intravenous and intraventricular amphotericin B.
- Surgical drainage of the abscess was performed.
- The patient experienced a successful clinical outcome with no recurrence.
Implications:
- This case highlights the importance of considering mucormycosis in intravenous drug users with neurological symptoms.
- Early diagnosis and aggressive multimodal treatment (antifungal therapy and surgery) are crucial for survival.
- This is only the second reported survival of primary cerebral mucormycosis in an intravenous drug abuser.