[Candida albicans meningo-encephalo-myelo-radiculitis at an addict].
Beside immunodepression induced by the human immunodeficiency virus, fungal infections of the central nervous system are extremely rare in heroin-addict patients. We report here a case of meningo-encephalitis with myelo-radicular lesions in a 25-year-old intravenous heroin addict but non-HIV patient, who was admitted for an acute confusion associated with gait disorders. The diagnosis of Candida albicans meningo-encephalo-myelo-radiculitis was established by magnetic resonance imagery and mycological and serological examinations of cerebrospinal fluid. The infection was cured with amphotericin B lipid complex and 5-fluorocytosine. Early diagnosis and antifungal therapy for 6 months resulted in a favorable outcome. The detection of circulating Candida mannan in cerebrospinal fluid with a more sensitive technique combined to MRI were particularly decisive to confirm Candida infection diagnosis, allowing an appropriate antifungal therapy.
Pihet
M
M
Laboratoire de parasitologie-mycologie, Hôpital Calmette, CHRU, Lille.
Poulain
D
D
De Sèze
J
J
Camus
D
D
Sendid
B
B
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000150:complications / Q000175:diagnosis*; D006556:Heroin Dependence / Q000150:complications* / Q000382:microbiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016921:Meningitis, Fungal / Q000150:complications / Q000382:microbiology*; D011843:Radiculopathy / Q000150:complications / Q000382:microbiology*; D016896:Treatment Outcome
D000935:Antifungal Agents