Meningitis caused by Candida species: an emerging problem in neurosurgical patients.
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.
Nguyen
M H
MH
University of Pittsburgh Medical Center, Pennsylvania, USA.
Yu
V L
VL
D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001921:Brain / Q000601:surgery; D002177:Candidiasis / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005437:Flucytosine / Q000627:therapeutic use; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000209:etiology; D016921:Meningitis, Fungal / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D008875:Middle Aged; D011183:Postoperative Complications / Q000382:microbiology
D000890:Anti-Infective Agents; D000935:Antifungal Agents; D000666:Amphotericin B; D005437:Flucytosine