Intradural cauda equina Candida abscess presenting with hydrocephalus: case report.

Area of Science:

• Infectious Diseases
• Neurology
• Medical Genetics

Background:

• Central nervous system (CNS) candidiasis typically presents as meningitis or microabscesses.
• Such infections often carry a poor prognosis.
• Candida albicans is an opportunistic fungal pathogen.

Observation:

• A patient presented with ventriculomegaly and a cauda equina mass.
• Surgical exploration revealed an intradural abscess.
• Fungal elements and Candida albicans were confirmed via microscopy and PCR.

Findings:

• Whole-exome sequencing identified heterozygous missense variants in CSF2 and RASGRF1.
• These genes are linked to protection from CNS candidiasis via CARD9 signaling.
• Variants in PLCG2, a lectin receptor involved in candidiasis, were also found.

Implications:

• Candida albicans can present as a cauda equina abscess, a rare manifestation.
• Genetic variants in immune-related genes may predispose individuals to CNS candidiasis.
• Hydrocephalus is a potential complication of intradural fungal abscesses.