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Candida albicans meningitis in a parenteral drug abuser
Southern Medical Journal
|March 1, 1984
Abstract:
We have described a patient with meningitis due to Candida albicans, in whom the only identifiable risk factor was a history of intravenous amphetamine abuse. Despite intravenous therapy with 2 gm of amphotericin B and concurrent 5-fluorocytosine, symptoms, CSF pleocytosis, and hypoglycorrhachia persisted. After a brief course of intrathecal amphotericin B therapy, the patient improved clinically and the CSF returned to normal.
Insights
This study reports a rare case of Candida albicans meningitis in an intravenous amphetamine abuser. Intrathecal amphotericin B proved effective when standard treatments failed, highlighting its potential in refractory cases.
Area of Science:
- Infectious Diseases
- Mycology
- Neurology
Background:
- Candida albicans meningitis is a rare but serious fungal infection affecting the central nervous system.
- Intravenous drug abuse, particularly with amphetamines, is an emerging risk factor for invasive fungal infections.
Observation:
- A patient with meningitis caused by Candida albicans presented with a history of intravenous amphetamine abuse as the sole identifiable risk factor.
- Initial treatment with intravenous amphotericin B and 5-fluorocytosine failed to resolve clinical symptoms, cerebrospinal fluid (CSF) pleocytosis, and hypoglycorrhachia.
Findings:
- A brief course of intrathecal amphotericin B administration led to significant clinical improvement.
- Cerebrospinal fluid parameters normalized following intrathecal therapy, indicating successful treatment of the fungal meningitis.
Implications:
- This case underscores the importance of considering invasive fungal infections in individuals with a history of intravenous drug abuse.
- Intrathecal amphotericin B may be a valuable therapeutic option for refractory cases of Candida meningitis unresponsive to conventional systemic treatments.
- Further research is warranted to elucidate the mechanisms linking amphetamine abuse to increased risk of fungal meningitis and to optimize treatment strategies.