The index case for the fungal meningitis outbreak in the United States.
Persistent neutrophilic meningitis presents a diagnostic challenge, because the differential diagnosis is broad and includes atypical infectious causes. We describe a case of persistent neutrophilic meningitis due to Aspergillus fumigatus in an immunocompetent man who had no evidence of sinopulmonary or cutaneous disease. An epidural glucocorticoid injection was identified as a potential route of entry for this organism into the central nervous system, and the case was reported to the state health department.
Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-2582, USA. april.pettit@vanderbilt.edu
April C
AC
Pettit
Jonathan A
JA
Kropski
Jessica L
JL
Castilho
Jonathan E
JE
Schmitz
Carol A
CA
Rauch
Bret C
BC
Mobley
Xuan J
XJ
Wang
Steven S
SS
Spires
Meredith E
ME
Pugh
D001228:Aspergillosis / Q000175:diagnosis* / Q000209:etiology; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D002531:Cerebellum / Q000098:blood supply; D002544:Cerebral Infarction / Q000209:etiology / Q000473:pathology; D002555:Cerebrospinal Fluid / Q000469:parasitology*; D003937:Diagnosis, Differential; D004196:Disease Outbreaks; D004340:Drug Contamination; D017809:Fatal Outcome; D005938:Glucocorticoids / Q000008:administration & dosage; D006261:Headache / Q000209:etiology; D006801:Humans; D007268:Injections, Epidural / Q000009:adverse effects; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000209:etiology; D017116:Low Back Pain / Q000188:drug therapy / Q000209:etiology; D008297:Male; D016921:Meningitis, Fungal / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014481:United States
D005938:Glucocorticoids