Meningitis caused by Rhodotorula rubra in an HIV-infected patient

Meningitis caused by Rhodotorula spp. in HIV-infected patients has not been reported previously. We present a brief review of the literature regarding medically important species of Rhodotorula and a case of meningitis caused by Rhodotorula rubra in an HIV-infected patient. The diagnosis was confirmed by the isolation of the fungus from the CSF. The course of Rhodotorula-induced meningitis was characterized by gradual development over several months, severe headache and high body temperature. No signs of damage to the meninx or inflammatory changes were observed. Therapy with 5-fluorocytosine for 15 days was successful in eliminating the yeast from the CSF. Eight months later the meningitis relapsed with R. rubra being recovered from the CSF. Suppressive therapy with itraconazole (400 mg daily during 3 months) followed by maintenance therapy (200 mg daily) eradicated the infection.