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Candida Meningitis


Presentation

  • The presentation of meningitis can be insidious in immunosuppressed patients and thus can be easily overlooked. Cerebrospinal fluid studies often resemble bacterial profiles, and cultures can be falsely negative.[ncbi.nlm.nih.gov]
  • We present a case of neonatal cerebrospinal fluid shunt-associated Candida meningitis, in which removal of the device was precluded, that was successfully treated with caspofungin.[ncbi.nlm.nih.gov]
  • She presented with vulva swelling, vaginal discharge and fever, with rapid progression to tonic-clonic convulsions and loss of consciousness. She fully recovered after treatment with fluconazole.[ncbi.nlm.nih.gov]
  • The case reports and literature review presented herein suggest that CGD should be suspected when a case of "primary" Candida meningitis is encountered.[ncbi.nlm.nih.gov]
  • Two patients with Candida meningitis are presented to emphasize cranial polyneuropathy and ventricular isolation with septation. These clinical and radiographic criteria can be used for early diagnosis and treatment.[ncbi.nlm.nih.gov]
Malaise
  • We present the case of an elderly woman who had symptoms such as headache, malaise, and fever for 8 months and was found to have Candida albicans meningitis, and we review 17 similar cases.[ncbi.nlm.nih.gov]
Bleeding Gums
  • With the development of the disease the temperature rises to 38 — 39 degrees, appear multiple rashes, increased salivation and viscosity of saliva, it becomes acidic, bleeding gums.[medicalj-center.info]
Poor Oral Hygiene
  • Oral thrush in children occurs when the hormone therapy, diseases of the gastrointestinal tract, antibiotics, diabetes, poor oral hygiene, extensive caries.[medicalj-center.info]
Psychomotor Retardation
  • Hydrocephalus and profound psychomotor retardation were present one year later.[ncbi.nlm.nih.gov]
  • One of eight infants who survived had psychomotor retardation; three of eleven infants developed hydrocephalus.[ncbi.nlm.nih.gov]
Headache
  • We present the case of an elderly woman who had symptoms such as headache, malaise, and fever for 8 months and was found to have Candida albicans meningitis, and we review 17 similar cases.[ncbi.nlm.nih.gov]
  • Strong headaches and muscle pain. Blood pressure falls, the rhythm of the heart. The bubbles spread all over the face, they hurt to touch.[medicalj-center.info]
  • 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.[ncbi.nlm.nih.gov]
  • Abstract A 16 year old female presented to us with a 15 days history of headache, stiff neck, fever and vomiting. On general physical examination, patient was lethargic and irritable.[pediatriconcall.com]
  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized[nejm.org]
Confusion
  • Candida albicans infection confused with tuberculosis. Arch Pathol 1943 ; 35 : 427 – 437. 2. Eschwege, J. Generalized moniliasis with localization in the brain. Arch Neurol Psychol 1958 ; 79 : 250. 3. Feigin, I, Prose, P.[cambridge.org]
  • You are confused. When should I contact my healthcare provider? You have a fever. You have questions or concerns about your condition or care. Care Agreement You have the right to help plan your care.[drugs.com]
  • Fast-forward months later: After intermittent episodes that included headaches, fatigue, vertigo/dizziness, and sometimes confusion, Tarantino was rushed to a hospital near his home.[sciencedaily.com]
  • [ edit ] Symptoms of fungal meningitis are generally similar to those of other types of meningitis, and include: a fever, stiff neck, severe headache, photophobia (sensitivity to light), nausea and vomiting, and altered mental status (drowsiness or confusion[en.wikipedia.org]
Neck Stiffness
  • Like other forms of meningitis, typical symptoms associated with fungal meningitis include fever and headache, neck stiffness/pain and deterioration of mental status (drowsiness, stupor and coma). Cranial nerve deficits and seizures can also occur.[nervous-system-diseases.com]
  • The neurological examination showed neck stiffness, positive Kernig’s sign, and negative Babinski sign on both sides.[nnjournal.net]
Altered Mental Status
  • Prognosis Cryptococcal meningitis The most important markers of poor prognosis in HIV-associated cryptococcal meningitis are altered mental status at presentation and high organism load, as determined by quantitative cerebrospinal fluid (CSF) culture[online.epocrates.com]
  • Signs and symptoms [ edit ] Symptoms of fungal meningitis are generally similar to those of other types of meningitis, and include: a fever, stiff neck, severe headache, photophobia (sensitivity to light), nausea and vomiting, and altered mental status[en.wikipedia.org]
Focal Neurologic Deficit
  • Several factors associated with poor prognosis were delineated in this study: diagnostic interval after symptomatic onset longer than two weeks, CSF glucose levels below 35 mg/100 ml and presence of intracranial hypertension and focal neurologic deficits[ncbi.nlm.nih.gov]

Treatment

  • There have been reports of treatment with intrathecal amphotericin B with variable clinical outcomes.[ncbi.nlm.nih.gov]
  • We performed a literature review with special focus on common risk factors, Candida species, diagnostic criteria, and treatment.[ncbi.nlm.nih.gov]
  • We report a newborn with Candida meningitis and arthritis who did well after treatment with intravenous and intrathecal amphotericin B, along with oral flucytosine.[ncbi.nlm.nih.gov]
  • We report the case of an 11-month-old child with acquired immunodeficiency syndrome, who despite treatment for systemic candidiasis developed undetected Candida meningitis.[ncbi.nlm.nih.gov]
  • Treatment with antimicrobials alone failed to sterilize the CSF. Cure was obtained only after removal of the shunt tubes.[ncbi.nlm.nih.gov]

Prognosis

  • Several factors associated with poor prognosis were delineated in this study: diagnostic interval after symptomatic onset longer than two weeks, CSF glucose levels below 35 mg/100 ml and presence of intracranial hypertension and focal neurologic deficits[ncbi.nlm.nih.gov]
  • Given the rarity of this infection, the epidemiology, prognosis, and optimal therapy for Candida meningitis are poorly defined. The authors report on a paraplegic patient due to spinal cord injury who developed C. tropicalis meningitis.[ncbi.nlm.nih.gov]
  • The duration of treatment is dependent upon the causal pathogen and the patient's ability to stave off the infection; for patients with a weaker immune system or diabetes, treatment will often take longer. [2] Prognosis [ edit ] Prognosis depends on the[en.wikipedia.org]
  • Prognosis Cryptococcal meningitis The most important markers of poor prognosis in HIV-associated cryptococcal meningitis are altered mental status at presentation and high organism load, as determined by quantitative cerebrospinal fluid (CSF) culture[online.epocrates.com]

Etiology

  • Etiology and management of chronic meningitis.. US Pharm 35 :, HS-2– – HS-8. [Google Scholar] Lipton S. A., Hickey W. F., Morris J. H., Loscalzo J.. ( 1984 ; ). Candidal infection in the central nervous system.. Am J Med 76 :, 101– – 108.[jmm.microbiologyresearch.org]
  • Etiology Infective pyogenic meningitis elderly Streptococcus pneumoniae Listeria monocytogenes Neisseria meningitidis Gram negative bacilli adults Streptococcus pneumoniae Neisseria meningitidis Group B streptococcus children Neisseria meningitidis infants[radiopaedia.org]

Epidemiology

  • Given the rarity of this infection, the epidemiology, prognosis, and optimal therapy for Candida meningitis are poorly defined. The authors report on a paraplegic patient due to spinal cord injury who developed C. tropicalis meningitis.[ncbi.nlm.nih.gov]
  • Secular trends in the epidemiology of nosocomial fungal infections in the United States, 1980-1990. National Nosocomial Infections Surveillance System. I Infect Dis 1993; 167:1247-51. ‎[books.google.de]
  • Epidemiology of candidemia in Brazil: a nationwide sentinel surveillance of candidemia in eleven medical centers.. J Clin Microbiol 44 :, 2816– – 2823. [CrossRef] [PubMed] [Google Scholar] de Repentigny L., Lewandowski D., Jolicoeur P.. ( 2004 ; ).[jmm.microbiologyresearch.org]
  • The ecology of Cryptococcus neoformans and the epidemiology of cryptococcosis. Rev Infect Dis 1991; 13: 1163-1169. Medline (7) Perfect JR, Granger DL, Durack DT.[aidscience.org]
Sex distribution
Age distribution

Pathophysiology

  • Unremarkable CSF parameters in the presence of Candida CNS infection are consistent with the pathophysiology of disease, because candidiasis of the CNS develops as a meningoencephalitis with subcortical and cortical granulomas, parenchymal abscesses and[nature.com]

Prevention

  • International conference for the development of a consensus on the management and prevention of severe candidal infections. Clin Infect Dis 1997;25:43-59. ‎ Seite 39 - Pfaller MA, Jones RN, Doern GV, et al.[books.google.de]
  • Medline (26) Centers for Disease Control and Prevention.[aidscience.org]
  • Prevention Many fungal infections can be prevented by taking certain precautions. For example, to reduce the risk of developing athlete’s foot, it’s important to keep your feet clean and dry.[sepsis.org]
  • The only way to prevent the spread of herpes virus that has high risk and the likelihood of transmission. Furthermore, timely diagnosis allows to eradicate the disease in its early stages.[medicalj-center.info]
  • While most people have been exposed to this fungus, their immune systems prevent Cryptococcus from causing disease.[thewellproject.org]

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