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Intracranial fungal aneurysm caused by Candida endocarditis
S Takeda1, K Wakabayashi, K Yamazaki
1Department of Pathology, Niigata Neurosurgical Hospital, Japan.
Abstract:
We describe a 67-year-old man who died 4 days after suffering a subarachnoid hemorrhage. Autopsy revealed a fresh subarachnoid hemorrhage and a ruptured fungal aneurysm near the trifurcation of the right middle cerebral artery. In comparison with 21 previously reported cases in which the fungal aneurysms were proved to be intracranial, the present case had several characteristic features: the causative fungus of the aneurysm was Candida (only one such case has been reported previously). The aneurysm was caused by direct Candida invasion of the arterial wall from the Candida embolus (previously reported aneurysms have been caused by direct invasion of the arterial wall during fungal meningitis). The source of the Candida was endocarditis (the main sources of fungus in previously reported cases have been sinusitis, dental extraction wounds, and some forms of surgery). We describe the features of this rare autopsy case of a ruptured fungal aneurysm caused by Candida originating from endocarditis and review the literature.
Insights
A rare case of fungal aneurysm caused by Candida from endocarditis led to subarachnoid hemorrhage. This autopsy study highlights unique features of Candida fungal aneurysms.
Area of Science:
- Neurology
- Infectious Diseases
- Pathology
Background:
- Fungal aneurysms are rare intracranial complications, often associated with fungal meningitis.
- Previous cases typically involved fungi originating from sinusitis or dental procedures.
Observation:
- A 67-year-old male presented with subarachnoid hemorrhage due to a ruptured fungal aneurysm.
- Autopsy revealed the aneurysm was caused by Candida, originating from endocarditis.
Findings:
- This case is unique as Candida was the causative agent and the source was endocarditis.
- The aneurysm resulted from direct arterial wall invasion by Candida emboli, differing from meningitis-related cases.
Implications:
- This case expands the known etiologies and sources of fungal aneurysms.
- Highlights the importance of considering endocarditis in fungal aneurysm pathogenesis, especially with Candida.