title: Candida meningitis in an immunocompetent patient detected through (1→3)-beta-d-glucan.
abstract: A 44-year-old female presented with a 3-month history of headache, dizziness, nausea, and vomiting. Her past medical history was significant for long-standing intravenous drug abuse. Shortly after admission, the patient became hypertensive and febrile, with fever as high as 38.8°C. The lumbar puncture profile supported an infectious process; however multiple cultures of blood and cerebrospinal fluid (CSF) did not initially show growth of organisms. Finally after 9 days of incubation, a CSF culture showed evidence of a few colonies of Candida albicans. To confirm the diagnosis, preserved CSF from that sample was tested for (1→3)-β-d-glucan, showing levels >500pg/ml. This report illustrates a rare complication of intravenous drug use in an immunocompetent patient and demonstrates the utility of (1→3)-β-d-glucan testing in possible Candida meningitis.
authors: West Virginia University School of Medicine, Morgantown, West Virginia, USA; Department of Medicine, West Virginia University Health Sciences Center, PO Box 91601, Medical Center Dr., Morgantown, WV 26506, USA. Electronic address: mfarrugia@hsc.wvu.edu.
authors: Mark K
authors: MK
authors: Farrugia
authors: West Virginia University School of Medicine, Morgantown, West Virginia, USA; Department of Medicine, West Virginia University Health Sciences Center, PO Box 91601, Medical Center Dr., Morgantown, WV 26506, USA.
authors: Evan P
authors: EP
authors: Fogha
authors: West Virginia University School of Medicine, Morgantown, West Virginia, USA; Department of Medicine, West Virginia University Health Sciences Center, PO Box 91601, Medical Center Dr., Morgantown, WV 26506, USA.
authors: Abdul R
authors: AR
authors: Miah
authors: West Virginia University School of Medicine, Morgantown, West Virginia, USA; Department of Medicine, West Virginia University Health Sciences Center, PO Box 91601, Medical Center Dr., Morgantown, WV 26506, USA.
authors: Joel
authors: J
authors: Yednock
authors: West Virginia University School of Medicine, Morgantown, West Virginia, USA; Department of Medicine, West Virginia University Health Sciences Center, PO Box 91601, Medical Center Dr., Morgantown, WV 26506, USA.
authors: H Carl
authors: HC
authors: Palmer
authors: West Virginia University School of Medicine, Morgantown, West Virginia, USA; Department of Medicine, West Virginia University Health Sciences Center, PO Box 91601, Medical Center Dr., Morgantown, WV 26506, USA.
authors: John
authors: J
authors: Guilfoose
mesh_terms: D000328:Adult; D002176:Candida albicans; D002177:Candidiasis / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D007121:Immunocompetence; D016921:Meningitis, Fungal / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D015819:Substance Abuse, Intravenous / Q000150:complications*; D047071:beta-Glucans / Q000134:cerebrospinal fluid*
chemical_list: D047071:beta-Glucans
keywords: (1→3)-β-d-glucan; Candida; Cerebrospinal fluid; Fungal; Intravenous drug abuse; Meningitis