[Candidiasis]

Area of Science:

• Infectious Diseases
• Immunology
• Neurology

Background:

• Central nervous system (CNS) candidiasis is a serious infection, particularly in immunocompromised individuals or those with neurosurgical devices.
• Diagnosis relies on identifying Candida in cerebrospinal fluid (CSF) cultures.
• Current treatment involves liposomal amphotericin B, potentially with flucytosine, followed by fluconazole if susceptible.

Purpose of the Study:

• To review the diagnosis and management of CNS candidiasis.
• To highlight the role of CARD9 deficiency in primary candidal meningitis.

Main Methods:

• Literature review of CNS candidiasis and CARD9 deficiency.
• Summary of current diagnostic standards and treatment guidelines.
• Discussion of diagnostic clues for CARD9 deficiency.

Main Results:

• CNS candidiasis treatment involves antifungal therapy and removal of CNS devices.
• Autosomal recessive CARD9 deficiency is linked to invasive candidiasis, including recurrent or drug-resistant meningitis.
• CARD9 deficiency is a key consideration for primary candidal meningitis without apparent immunodeficiency.

Conclusions:

• Effective management of CNS candidiasis requires timely diagnosis and appropriate antifungal treatment.
• Investigating CARD9 deficiency is crucial for patients with unexplained or recurrent candidal meningitis.
• A history of chronic mucocutaneous candidiasis can indicate underlying CARD9 deficiency.