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Case Report: Candida dubliniensis as a Cause of Chronic Meningitis

Background: Candida dubliniensis is closely related to Candida albicans and rarely isolated in clinical specimens. C. dubliniensis is increasingly recognized as a pathogen in immunocompromised hosts. We present the third known case of Candida dubliniensis meningitis in a young immunocompetent host....

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Autores principales: Tahir, Madiha, Peseski, Andrew M., Jordan, Stephen J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752766/
https://www.ncbi.nlm.nih.gov/pubmed/33363510
http://dx.doi.org/10.3389/fneur.2020.601242
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author Tahir, Madiha
Peseski, Andrew M.
Jordan, Stephen J.
author_facet Tahir, Madiha
Peseski, Andrew M.
Jordan, Stephen J.
author_sort Tahir, Madiha
collection PubMed
description Background: Candida dubliniensis is closely related to Candida albicans and rarely isolated in clinical specimens. C. dubliniensis is increasingly recognized as a pathogen in immunocompromised hosts. We present the third known case of Candida dubliniensis meningitis in a young immunocompetent host. Case Presentation: A 27-year-old female with a history of intravenous heroin use and chronic hepatitis C presented with a 10-month history of headaches and progressive bilateral vision loss. On physical examination, visual acuity was 20/20 in her right eye and grade II papilledema was noted. Examination of her left eye revealed complete loss of vision and grade IV papilledema. An MRI with and without contrast revealed increased leptomeningeal enhancement involving the posterior fossa and spinal cord. After multiple lumbar punctures, cerebrospinal fluid fungal cultures grew Candida dubliniensis. The patient was successfully treated with a combination of liposomal amphotericin and fluconazole for 6 weeks with complete resolution of her CNS symptoms, with the exception of irreversible vision loss. Conclusion: We report a case of chronic meningitis due to Candida dubliniensis in an immunocompetent woman with hepatitis C and a history of intravenous heroin use. Additional studies are needed to confirm risk factors for Candida dubliniensis colonization, which likely predisposes individuals to invasive candidiasis.
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spelling pubmed-77527662020-12-23 Case Report: Candida dubliniensis as a Cause of Chronic Meningitis Tahir, Madiha Peseski, Andrew M. Jordan, Stephen J. Front Neurol Neurology Background: Candida dubliniensis is closely related to Candida albicans and rarely isolated in clinical specimens. C. dubliniensis is increasingly recognized as a pathogen in immunocompromised hosts. We present the third known case of Candida dubliniensis meningitis in a young immunocompetent host. Case Presentation: A 27-year-old female with a history of intravenous heroin use and chronic hepatitis C presented with a 10-month history of headaches and progressive bilateral vision loss. On physical examination, visual acuity was 20/20 in her right eye and grade II papilledema was noted. Examination of her left eye revealed complete loss of vision and grade IV papilledema. An MRI with and without contrast revealed increased leptomeningeal enhancement involving the posterior fossa and spinal cord. After multiple lumbar punctures, cerebrospinal fluid fungal cultures grew Candida dubliniensis. The patient was successfully treated with a combination of liposomal amphotericin and fluconazole for 6 weeks with complete resolution of her CNS symptoms, with the exception of irreversible vision loss. Conclusion: We report a case of chronic meningitis due to Candida dubliniensis in an immunocompetent woman with hepatitis C and a history of intravenous heroin use. Additional studies are needed to confirm risk factors for Candida dubliniensis colonization, which likely predisposes individuals to invasive candidiasis. Frontiers Media S.A. 2020-12-08 /pmc/articles/PMC7752766/ /pubmed/33363510 http://dx.doi.org/10.3389/fneur.2020.601242 Text en Copyright © 2020 Tahir, Peseski and Jordan. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Tahir, Madiha
Peseski, Andrew M.
Jordan, Stephen J.
Case Report: Candida dubliniensis as a Cause of Chronic Meningitis
title Case Report: Candida dubliniensis as a Cause of Chronic Meningitis
title_full Case Report: Candida dubliniensis as a Cause of Chronic Meningitis
title_fullStr Case Report: Candida dubliniensis as a Cause of Chronic Meningitis
title_full_unstemmed Case Report: Candida dubliniensis as a Cause of Chronic Meningitis
title_short Case Report: Candida dubliniensis as a Cause of Chronic Meningitis
title_sort case report: candida dubliniensis as a cause of chronic meningitis
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752766/
https://www.ncbi.nlm.nih.gov/pubmed/33363510
http://dx.doi.org/10.3389/fneur.2020.601242
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