Mould meningitis associated with intravenous drug use

Area of Science:

• Infectious Diseases
• Neurology
• Mycology

Background:

• Fungal meningitis is typically caused by Cryptococcus species and dimorphic fungi.
• Mould meningitis is a rare but serious fungal infection affecting the central nervous system.

Purpose of the Study:

• To report a rare case of mould meningitis, ventriculitis, and subependymal nodules in an immunocompetent individual.
• To highlight diagnostic challenges and potential routes of infection in fungal meningitis.

Main Methods:

• Case report presentation.
• Review of clinical presentation, diagnostic procedures, and treatment.
• Discussion of diagnostic limitations and alternative approaches.

Main Results:

• A rare case of mould meningitis, ventriculitis, and subependymal nodules was observed in an immunocompetent patient.
• Intravenous drug use was identified as the likely source of infection seeding the meninges and ventricular system.
• The specific causative mould species remained undetermined.
• Cerebrospinal fluid (CSF) culture demonstrated poor sensitivity in identifying the fungal pathogen.

Conclusions:

• The case underscores the diagnostic difficulties associated with mould meningitis.
• Surgical biopsy should be considered in cases of diagnostic uncertainty where fungal infection is suspected.
• Further research into sensitive diagnostic methods for fungal meningitis is warranted.