Related Experiment Videos
Meningitis caused by Candida species: an emerging problem in neurosurgical patients
1University of Pittsburgh Medical Center, Pennsylvania, USA.
Abstract:
Three cases of candida meningitis were encountered in a 3-year period in our hospital; all occurred in neurosurgical patients. We describe these three cases and review the 15 cases of neurosurgery-related candida meningitis previously reported in the English-language literature. Data regarding these 18 patients formed the basis for our review. Most patients with candida meningitis had recently received antibacterial agents, and it is notable that 50% of patients suffered from antecedent bacterial meningitis. The CSF analysis revealed neutrophilic pleocytosis that was indistinguishable from that of bacterial meningitis. The overall mortality was 11%. Administration of amphotericin B combined with flucytosine appeared to be the best therapeutic approach for candida meningitis.
Insights
Candida meningitis is a rare but serious infection primarily affecting neurosurgical patients. Early diagnosis and combination therapy with amphotericin B and flucytosine show promise in improving outcomes.
Area of Science:
- Infectious Diseases
- Neurosurgery
- Mycology
Background:
- Candida meningitis is a rare fungal infection.
- Neurosurgical patients are at increased risk.
- Previous literature on neurosurgery-related Candida meningitis is limited.
Observation:
- Three new cases of Candida meningitis were observed in neurosurgical patients over three years.
- A review of 18 cases (3 new + 15 literature) was conducted.
- Most patients had recent antibiotic use and 50% had prior bacterial meningitis.
Findings:
- Cerebrospinal fluid (CSF) analysis showed neutrophilic pleocytosis, mimicking bacterial meningitis.
- The overall mortality rate for these cases was 11%.
- Combination therapy with amphotericin B and flucytosine was identified as the optimal treatment.
Implications:
- Highlights the importance of considering fungal meningitis in neurosurgical patients, especially after antibiotic treatment.
- Emphasizes the diagnostic challenge posed by similar CSF findings to bacterial meningitis.
- Suggests a preferred therapeutic regimen for improved patient outcomes in Candida meningitis.