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[Candida meningitis. Case report].

A Knuth, W Dippold, G Krämer

Deutsche Medizinische Wochenschrift (1946)

|July 8, 1983

Summary

This case study details a rare Candida albicans meningitis in a young woman. Despite slow initial response to treatment, she ultimately achieved a full recovery with normal cerebrospinal fluid.

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Area of Science:

Infectious Diseases
Neurology
Mycology

Background:

Subacute meningitis is a rare but serious infection of the central nervous system.
Candida albicans is an opportunistic fungal pathogen that can cause invasive infections, including meningitis, particularly in immunocompromised individuals.
Fungal meningitis can present with subacute onset, making diagnosis and treatment challenging.

Observation:

A 19-year-old female presented with subacute meningitis confirmed as Candida albicans by culture and immunoserology.
Initial treatment with amphotericin B and flucytosine showed slow clinical improvement, with persistent cerebrospinal fluid (CSF) pleocytosis.
The patient experienced an unusual neurological-otological symptom of intermittent inner-ear deafness prior to treatment.

Findings:

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Despite persistent CSF pleocytosis, falling Candida antibody titers in serum and CSF indicated a positive response to antifungal therapy.
Treatment was discontinued after 42 days due to adverse effects, including fever and polyuria.
Complete cure was achieved with normal CSF findings after serial clinical observation and occasional lumbar punctures.

Implications:

This case highlights the potential for successful treatment of Candida albicans meningitis even with slow initial response and treatment discontinuation due to side effects.
The unusual neurological-otological symptoms and auditory evoked potential findings suggest cranial nerve involvement in the inflammatory process.
Early auditory evoked potentials may aid in diagnosing neurological complications associated with fungal meningitis.