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Case Report: Successful Treatment of Recurrent Candida Albicans Meningitis with Kimura’s Disease Using Amphotericin B Colloidal Dispersion Combined with Fluconazole
BACKGROUND: Candida albicans meningitis is a fungal infectious disease of the central nervous system that most often occurs in immunodeficient populations. Kimura’s disease is an IgE-mediated inflammatory reactive disease that is a chronic immune disorder with predominantly lymph node, soft tissue,...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10617790/ https://www.ncbi.nlm.nih.gov/pubmed/37915503 http://dx.doi.org/10.2147/IDR.S416040 |
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author | Shen, Huijun Zhou, Hong Zhang, Fang Wang, Jing Wang, Rui Wang, Jie |
author_facet | Shen, Huijun Zhou, Hong Zhang, Fang Wang, Jing Wang, Rui Wang, Jie |
author_sort | Shen, Huijun |
collection | PubMed |
description | BACKGROUND: Candida albicans meningitis is a fungal infectious disease of the central nervous system that most often occurs in immunodeficient populations. Kimura’s disease is an IgE-mediated inflammatory reactive disease that is a chronic immune disorder with predominantly lymph node, soft tissue, and salivary gland damage, the treatment of which is hormone-based. The combination of Kimura’s disease with C. albicans meningitis is relatively uncommon. Herein, we report a case of C. albicans meningitis in combination with Kimura’s disease. CASE PRESENTATION: The case is a 26-year-old male with a medical history of Kimura, who presented with symptoms of dizziness, headache, and double vision. Lumbar puncture and cerebrospinal fluid examination revealed an increased white blood cell count. Further analysis through cerebrospinal fluid culture and metagenomic second-generation sequencing (mNGS) led to the final diagnosis of C. albicans meningitis. The patient was treated with fluconazole after the onset of C. albicans meningitis and had a good response. During the treatment, changes in the pathogen genome sequences were monitored dynamically using metagenomic next-generation sequencing. After 1 year, the patient had a recurrence of Candida meningitis. Treatment with fluconazole alone was ineffective, while antifungal treatment with amphotericin B colloidal dispersion was effective with no detectable renal injury. CONCLUSION: Candida meningitis can occur in the context of Kimura disease. In patients with mild disease, the possibility of recurrence exists with fluconazole treatment alone, and the efficacy of amphotericin B colloidal dispersion combined with fluconazole is better than fluconazole alone in patients with a recurrence. No nephrotoxicity was observed during amphotericin B colloidal dispersion treatment. The mNGS allows dynamic monitoring of pathogen sequencing reads, and for Candida meningitis, there may be a mismatch between peak sequencing reads and disease during treatment, the basis for which is unclear. |
format | Online Article Text |
id | pubmed-10617790 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-106177902023-11-01 Case Report: Successful Treatment of Recurrent Candida Albicans Meningitis with Kimura’s Disease Using Amphotericin B Colloidal Dispersion Combined with Fluconazole Shen, Huijun Zhou, Hong Zhang, Fang Wang, Jing Wang, Rui Wang, Jie Infect Drug Resist Case Report BACKGROUND: Candida albicans meningitis is a fungal infectious disease of the central nervous system that most often occurs in immunodeficient populations. Kimura’s disease is an IgE-mediated inflammatory reactive disease that is a chronic immune disorder with predominantly lymph node, soft tissue, and salivary gland damage, the treatment of which is hormone-based. The combination of Kimura’s disease with C. albicans meningitis is relatively uncommon. Herein, we report a case of C. albicans meningitis in combination with Kimura’s disease. CASE PRESENTATION: The case is a 26-year-old male with a medical history of Kimura, who presented with symptoms of dizziness, headache, and double vision. Lumbar puncture and cerebrospinal fluid examination revealed an increased white blood cell count. Further analysis through cerebrospinal fluid culture and metagenomic second-generation sequencing (mNGS) led to the final diagnosis of C. albicans meningitis. The patient was treated with fluconazole after the onset of C. albicans meningitis and had a good response. During the treatment, changes in the pathogen genome sequences were monitored dynamically using metagenomic next-generation sequencing. After 1 year, the patient had a recurrence of Candida meningitis. Treatment with fluconazole alone was ineffective, while antifungal treatment with amphotericin B colloidal dispersion was effective with no detectable renal injury. CONCLUSION: Candida meningitis can occur in the context of Kimura disease. In patients with mild disease, the possibility of recurrence exists with fluconazole treatment alone, and the efficacy of amphotericin B colloidal dispersion combined with fluconazole is better than fluconazole alone in patients with a recurrence. No nephrotoxicity was observed during amphotericin B colloidal dispersion treatment. The mNGS allows dynamic monitoring of pathogen sequencing reads, and for Candida meningitis, there may be a mismatch between peak sequencing reads and disease during treatment, the basis for which is unclear. Dove 2023-10-27 /pmc/articles/PMC10617790/ /pubmed/37915503 http://dx.doi.org/10.2147/IDR.S416040 Text en © 2023 Shen et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Case Report Shen, Huijun Zhou, Hong Zhang, Fang Wang, Jing Wang, Rui Wang, Jie Case Report: Successful Treatment of Recurrent Candida Albicans Meningitis with Kimura’s Disease Using Amphotericin B Colloidal Dispersion Combined with Fluconazole |
title | Case Report: Successful Treatment of Recurrent Candida Albicans Meningitis with Kimura’s Disease Using Amphotericin B Colloidal Dispersion Combined with Fluconazole |
title_full | Case Report: Successful Treatment of Recurrent Candida Albicans Meningitis with Kimura’s Disease Using Amphotericin B Colloidal Dispersion Combined with Fluconazole |
title_fullStr | Case Report: Successful Treatment of Recurrent Candida Albicans Meningitis with Kimura’s Disease Using Amphotericin B Colloidal Dispersion Combined with Fluconazole |
title_full_unstemmed | Case Report: Successful Treatment of Recurrent Candida Albicans Meningitis with Kimura’s Disease Using Amphotericin B Colloidal Dispersion Combined with Fluconazole |
title_short | Case Report: Successful Treatment of Recurrent Candida Albicans Meningitis with Kimura’s Disease Using Amphotericin B Colloidal Dispersion Combined with Fluconazole |
title_sort | case report: successful treatment of recurrent candida albicans meningitis with kimura’s disease using amphotericin b colloidal dispersion combined with fluconazole |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10617790/ https://www.ncbi.nlm.nih.gov/pubmed/37915503 http://dx.doi.org/10.2147/IDR.S416040 |
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