Cerebral candidiasis: case report of brain abscess secondary to Candida albicans, and review of literature

Black, Joseph T.

doi:10.1136/jnnp.33.6.864

Cited by 78 publications

(17 citation statements)

References 21 publications

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“…such as C. tropicalis , C. parapsilosis , C. glabrata and C. lusitaniae have also been reported (Sarma et al , 1993; Voice et al , 1994; Fernandez et al , 2000; Hawkins & Baddour, 2003; Chen et al , 2004). Among adult patients with cancer and systemic candidiasis, 1–6% have been shown to have CNS involvement at autopsy (Bodey et al , 1992; Kume et al , 2003), but the diagnosis is made before autopsy in <20% of cases (Black, 1970; Go et al , 2000).…”

Section: Opportunistic Infectionsmentioning

confidence: 99%

Management of intracranial fungal infections in patients with haematological malignancies

Mattiuzzi

Giles

2005

Br J Haematol

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SummaryThe incidence of, and mortality associated with, invasive fungal infections remains far higher than hoped. As a consequence of the overall increase in the incidence of such infections over time, the incidence of central nervous system (CNS) fungal infections is also increasing and, despite improvements in diagnostic techniques and the introduction of novel antifungal agents, therapy for CNS infections is still associated with discouragingly poor results. In patients with haematological malignancies, opportunistic infections with Candida or Aspergillus remain the most common infections affecting the CNS; however, opportunistic infections with less well-known fungi are becoming more common and must be considered in the differential diagnosis. New techniques for the early diagnosis of invasive fungal infections are emerging. Pharmacologic options for treating invasive fungal infections have also improved during the past few years, with new drugs becoming available that have broader antifungal spectra and better safety profiles. Other novel treatment approaches, such as combination therapy, are also being explored. Early investigations have produced encouraging results; however, large, prospective studies involving many patients are necessary to validate the widespread use of these approaches. This review analyses the existing guidelines for treatment of CNS fungal infections and the literature available on the use of new drugs to generate sets of recommendations for treatment of these life-threatening infections in patients with haematological malignancies.

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Section: Opportunistic Infectionsmentioning

confidence: 99%

Management of intracranial fungal infections in patients with haematological malignancies

Mattiuzzi

Giles

2005

Br J Haematol

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“…Ventricular fluid has been positive for Candida organisms when they were not present in the lumbar space, from which they were cultured only weeks later. The survival rate in patients with meningitis approaches 83 per cent, but only one of 16 patients with brain abscesses was living four months after diagnosis and treatment (Black 1970). Poor prognostic factors include: diagnostic interval after symptomatic onset greater than two weeks; CSF glucose below 35mg/dl; and development of intracranial hypertension and focal neurological deficits (Bayer et af.…”

Section: Discussionmentioning

confidence: 99%

Mixed Bacterial and Fungal Meningitis in a Neonate

Ehlers¹,

Jarrett²,

Kaplan³

1979

Develop Med Child Neuro

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SUMMARY Mixed infections of the central nervous system occurring in children without underlying neurological disease may be more frequent than previously suspected. In this case report, a neonate whose cerebrospinal fluid culture at 24 hours showed group B streptococcus only, was found on postmortem examination at six days of age to have disseminated candidiasis with cerebral abscesses. The degree of systemic involvement in this newborn suggested intra‐uterine acquired candidiasis. Early diagnosis of polymicrobic infections is difficult, but this case suggests it should be considered in patients not responding to antibiotic therapy. RÉSUMÉ Méningites mixtes, bactériennes et fungiques chez un nouveau‐né Les infections mixtes du système nerveux central survenant chez des enfants sans affection neurologique sous‐jacente, peuvent être plus fréquentes qu'il n'est classique de le dire. Dans le cas rapporté, il fut notéà l'examen post‐mortem à six jours, une candidiose disséminée avec abcés cérébraux chez un nouveau‐né dont la culture de LCR à 24 heures avait seulement montré un streptocoque du groupe B. Le degré d'atteinte systémique chez ce nouveau‐né suggère une candidiose acquise en voie intra‐utérine. Le diagnostic précoce d'infection polymicrobienne est difficile, mais ce cas suggére qu'il devrait être envisageé chez les sujets ne répondant pas à la thérapeutique antibiotique. ZUSAMMENFASSUNG Meningitis bei einem Neugeborenen durch Mischinfektion von Bakterien und Pilzen Mischinfektionen des Zentralnervensystems bei Kindern ohne zugrundeliegende neurologische Erkrankung scheinen häufiger zu sein als bisher angenommen. Bei diesem Fallbericht handelt es sich um ein Neugeborenes, in dessen Liquor, der nach 24 Stunden gewonnen wurde, nur Streptokokken der Gruppe B nachgewiesen werden konnten und bei dem die post mortem Untersuchung am sechsten Tag eine disseminierte Candidiasis mit cerebralen Abszessen ergab. Das Ausmaß des systemischen Befalls bei diesem Neugeborenen läßt an eine intrauterin erworbene Candidiasis denken. Die Frühdiagnose von Mischinfektionen ist schwierig; dieser Fall jedoch zeigt, daß sie bei Patienten, die nicht auf Antibiotika ansprechen, in Betracht gezogen werden sollten. RESUMEN Meningitis mixta, bacteriana y fungica en el recién nacido Las infecciones mixtas en el sistema nervioso central que aparecen en niños sin patología neurológica subyacente pueden ser más frecuentes de lo que se creía hasta ahora. En el caso que se aporta, un recién nacido en cuyo IXR se cultivó a las 24 horas solamente un estreptococo del grupo B, se halló en el exámen post‐mortem a los seis dias de edad que presentaba una candidiasis diseminada con abscesos cerebrales. El grado de alteración sistémica en este recién nacido sugiere que se trataba de una candidiasis adquirida intrauterina. El diagnóstico precoz de las infecciones polimicrobianas es díficil pero el caso presente sugiere que deben ser consideradas en pacientes que no responden a la terapia antibiótica.

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“…with spread usually he matogenous from an intestinal, respiratory, cardiac, or intravenous cathe ter source [Fetter et al, 1967]. Brain involvement is reportedly rare [Smith and Sano, 1933;N ezelof and Sarrut, 1957;de V ita et al, 1966;F etter et al, 1967;V orreith, 1968;Black, 1970;Issel. 1970] Fig.…”

Section: Commentmentioning

confidence: 99%