title: Candida cerebral abscesses: a case report and review of the literature.
abstract: Cerebral abscess caused by Candida spp. is a rare disease, with a nonspecific presentation, little data on treatment, and generally poor outcomes. We present a case of this type of Candida infection in a 57-year-old man with a history of uncontrolled diabetes mellitus and intravenous drug abuse, and review the literature on this disease. Our patient had a good treatment outcome with liposomal amphotericin B and flucytosine, followed by oral fluconazole. Comorbidities include prior antibiotic use (52%), prior surgery (28%), malignancy (28%), stem cell or solid organ transplant (20%), prior corticosteroid use (16%), central venous catheter (CVC) insertion (10%), and burns (7%). Diagnosis requires a high index of suspicion, as clinical presentations and laboratory data can be nonspecific and difficult to differentiate from bacterial cerebral abscesses. In reviewed cases, 55% of blood cultures and 23% of cerebrospinal fluid (CSF) cultures were positive for Candida spp. and outcomes were poor, as the mortality rate of the non-autopsy cases reviewed was 69%.
authors: * Department of Internal Medicine.
authors: Andrea M
authors: AM
authors: Fennelly
authors: Amy K
authors: AK
authors: Slenker
authors: Lara C
authors: LC
authors: Murphy
authors: Michael
authors: M
authors: Moussouttas
authors: Joseph A
authors: JA
authors: DeSimone
mesh_terms: D061605:Administration, Intravenous; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D001922:Brain Abscess / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology*; D002175:Candida / Q000302:isolation & purification*; D002177:Candidiasis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology*; D002675:Child, Preschool; D048909:Diabetes Complications; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D005437:Flucytosine / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015819:Substance Abuse, Intravenous / Q000150:complications; D055815:Young Adult
chemical_list: C068538:liposomal amphotericin B; D000666:Amphotericin B; D015725:Fluconazole; D005437:Flucytosine