Chronic Candida dubliniensis meningitis in a lung transplant recipient

Area of Science:

• Infectious Diseases
• Transplantation Medicine
• Mycology

Background:

• Candida species commonly colonize the oral and respiratory tracts of lung transplant recipients.
• While often non-pathogenic, donor-derived Candida infections can occur, posing risks.
• Chronic meningitis is a rare but severe manifestation of invasive candidiasis, difficult to diagnose.

Observation:

• A lung transplant recipient developed empyema, successfully treated, followed by chronic meningitis.
• The meningitis was suspected to be a possible donor-derived Candida dubliniensis infection.
• Cerebrospinal fluid cultures yielded low results, delaying diagnosis.

Findings:

• Diagnosis was confirmed using fungal PCR and Beta-D-glucan assay.
• These advanced diagnostic methods proved crucial for identifying the fungal meningitis.
• The case highlights a rare presentation of invasive candidiasis post-transplantation.

Implications:

• Early diagnosis of invasive fungal infections in transplant recipients is critical.
• Advanced diagnostics like fungal PCR and BD glucan assays are vital when cultures are negative.
• This case underscores the potential for rare, severe donor-derived infections in immunocompromised patients.