"Unexplained" delayed death from fungal meningitis after meningioma resection.
BACKGROUND
Progressive deterioration and ensuing death following a neurosurgical procedure often represents a diagnostic challenge to the team responsible for patient care. Many, but not all, causes are treatable if a diagnosis is made early.


METHODS
A 69-year-old woman who died 6 weeks post-operatively following a meningioma resection is reported. An initial routine post-operative course became complicated by progressive neurological deterioration 3-4 weeks later. Despite extensive investigation she died 6 weeks post-operatively without a diagnosis.


RESULTS
Autopsy demonstrated extensive Candida meningitis. A review of the literature demonstrates this to be a reported complication in high risk patients, difficult to diagnose, but treatable when identified.


CONCLUSIONS
Fungal meningitis should be high in the differential diagnosis in the post-operative patient with delayed, unexplained neurological deterioration, especially when associated with negative CSF cultures.
Division of Neurosurgery, St. Michael's Hospital, Toronto, Ontario, Canada.
R J
RJ
Hurlbert
J M
JM
Bilbao
W S
WS
Tucker
D000368:Aged; D003643:Death; D005260:Female; D006801:Humans; D008579:Meningioma / Q000601:surgery*; D008581:Meningitis / Q000175:diagnosis* / Q000473:pathology*; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome