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Chronic blastomycotic meningitis

G R Kravitz, S F Davies, M R Eckman

    The American Journal of Medicine
    |September 1, 1981
    PubMed
    Summary
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    Blastomycosis can cause chronic meningitis, often presenting without systemic signs. Ventricular fluid culture is crucial for diagnosing this rare fungal meningitis, especially when lumbar taps are inconclusive.

    Area of Science:

    • Mycology
    • Neurology
    • Infectious Diseases

    Background:

    • Blastomycosis is a fungal infection typically affecting the lungs and skin.
    • Chronic meningitis can be caused by various pathogens, making diagnosis challenging.
    • Blastomycotic meningitis is a rare but serious complication of Blastomycosis.

    Observation:

    • Three cases of blastomycosis presenting as chronic meningitis were observed.
    • Patients developed obstructive hydrocephalus during the course of their meningitis.
    • Cerebrospinal fluid from lumbar taps was often non-diagnostic.

    Findings:

    • Cultures of ventricular fluid successfully identified Blastomyces in all three patients.
    • One patient experienced a full recovery after amphotericin B treatment.

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  • Diagnosis was difficult without obvious systemic blastomycosis.

    • Implications:

    • Blastomycosis should be considered in the differential diagnosis of chronic meningitis.
    • Sampling cisternal or ventricular fluid may improve diagnostic yield.
    • Early and accurate diagnosis is critical for effective treatment and patient outcomes.