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A Rare Central Nervous System Fungal Infection Resulting from Brown Heroin Use
Eric M Melnychuk1, David P Sole1
1Department of Emergency Medicine, Geisinger Medical Center, Danville, Pennsylvania.
The Journal of Emergency Medicine
|October 12, 2016
Summary
Fungal central nervous system infections are challenging to diagnose. This case highlights a rare complication of intravenous brown heroin use leading to vision loss from fungal meningitis and endophthalmitis.
Area of Science:
- Neurology
- Infectious Diseases
- Ophthalmology
Background:
- Fungal nervous system infections present diagnostic challenges due to nonspecific symptoms and difficulties in laboratory confirmation.
- Intravenous drug use, particularly with brown heroin, is associated with an increased risk of opportunistic fungal infections.
Observation:
- A young male presented with unilateral visual field deficits.
- Physical examination suggested a fungal infection consistent with brown heroin use, despite initial denial of intravenous drug abuse.
Findings:
- The patient was diagnosed with meningitis, ventriculitis, and endogenous endophthalmitis caused by Candida species.
- Successful treatment involved vitrectomy and broad-spectrum antimicrobial therapy.
Implications:
- Emergency physicians should consider fungal central nervous system infections in patients with compatible risk factors and symptoms.
- Early recognition and prompt treatment are crucial for managing vision loss and neurological complications associated with fungal infections in intravenous drug users.