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Author Spotlight: Oral Candida Diagnosis to Advance Clinical Treatment Regimen for pSS Patients

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Post-COVID-19 neurocandidiasis.

Miguel A Miranda¹, Sandra C Sousa², Vera L Montes²

¹Neurology Unit, Hospital de Cascais Dr. José de Almeida, Cascais, Portugal. miguel.silva.miranda@hospitaldecascais.pt.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

|August 9, 2021

Summary

This summary is machine-generated.

Neurocandidiasis, a severe fungal infection, can affect immunocompromised patients. This case highlights a fatal neurocandidiasis outcome in a COVID-19 patient despite aggressive antifungal treatment.

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Published on: November 7, 2020

Area of Science:

Infectious Diseases
Mycology
Neurology

Background:

Neurocandidiasis is a severe, often fatal, central nervous system infection caused by Candida species.
It primarily affects severely immunocompromised individuals, particularly those with recent antibiotic or corticosteroid use.
Risk factors include invasive procedures, indwelling devices, and prolonged hospitalization.

Observation:

A 70-year-old male, admitted to the ICU for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia, developed fever, coma, and multifocal neurological deficits 13 days post-extubation.
Candida albicans was isolated from urine and blood cultures.
Brain MRI revealed multiple gadolinium-enhanced ring lesions, suggestive of abscesses or inflammation.

Findings:

The patient was diagnosed with neurocandidiasis based on clinical presentation, microbiological findings, and neuroimaging.
Aggressive antifungal therapy was initiated promptly.
Despite treatment, the patient developed hospital-acquired pneumonia and ultimately succumbed to the infection.

Implications:

This case underscores the critical need for high clinical suspicion for neurocandidiasis in immunocompromised patients presenting with neurological deterioration.
Early diagnosis and aggressive antifungal treatment are crucial, but outcomes remain challenging, especially in critically ill patients.
The potential for invasive fungal infections like neurocandidiasis in the context of viral pneumonia and intensive care unit stays warrants further investigation.