Recurrent Candida tropicalis meningitis

Nancy L. Dawson, Hector A. Robles, Salvador Alvarez

Research output: Contribution to journalArticle

Abstract

Candida meningitis, a previously rare occurrence, has been increasing in prevalence and often is a result of complications of neurosurgery. We describe the case of a 49-year-old man who presented with headache, vertigo, intermittent blurred vision, and multiple episodes of nausea and vomiting. Computed tomography (CT) showed a left cerebellar hemorrhage with obliteration of the fourth ventricle causing hydrocephalus. He had an occipital craniotomy with transcondylar evacuation of the hemorrhage and placement of a temporary ventriculostomy. The hospital stay was prolonged because of postsurgical complications, and Candida tropicalis meningitis developed. Treatment was started with 400 mg of fluconazole administered intravenously every 12 h. In vitro susceptibility testing showed a minimum inhibitory concentration (MIC) to fluconazole of 1 μg/mL. Fluconazole was therefore continued orally for a total of 60 days, and the patient remained asymptomatic for 2 years. He then presented with increased vertigo and ataxia. Cerebrospinal fluid cultures grew C. tropicalis, which again showed susceptibility to fluconazole with a MIC of 1 μg/mL, identical to that in the previous infection. However, a second course of fluconazole failed to control the infection despite adequate cerebrospinal fluid levels.

Original languageEnglish (US)
Pages (from-to)243-245
Number of pages3
JournalClinical Neurology and Neurosurgery
Volume107
Issue number3
DOIs
StatePublished - Apr 2005
Externally publishedYes

Fingerprint

Candida tropicalis
Fluconazole
Meningitis
Vertigo
Microbial Sensitivity Tests
Cerebrospinal Fluid
Ventriculostomy
Hemorrhage
Fourth Ventricle
Craniotomy
Neurosurgery
Ataxia
Hydrocephalus
Infection Control
Candida
Nausea
Vomiting
Headache
Length of Stay
Tomography

Keywords

  • Candida tropicalis
  • Fluconazole
  • Meningitis
  • Microbial sensitivity tests
  • Treatment failure

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Neurology

Cite this

Recurrent Candida tropicalis meningitis. / Dawson, Nancy L.; Robles, Hector A.; Alvarez, Salvador.

In: Clinical Neurology and Neurosurgery, Vol. 107, No. 3, 04.2005, p. 243-245.

Research output: Contribution to journalArticle

Dawson, Nancy L. ; Robles, Hector A. ; Alvarez, Salvador. / Recurrent Candida tropicalis meningitis. In: Clinical Neurology and Neurosurgery. 2005 ; Vol. 107, No. 3. pp. 243-245.
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