Candida meningitis after transphenoidal surgery: a single institution case-series and literature review.

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Candida meningitis after transphenoidal surgery: a single institution case-series and literature review.

World Neurosurg. 2017 Aug 25;:

Authors: Bridges KJ, Li R, Fleseriu M, Cetas JS

Abstract
Candida meningitis following neurosurgical procedures is a rare, but potentially devastating complication. The presentation of meningitis can be insidious in immunosuppressed patients and thus can be easily overlooked. Cerebrospinal fluid studies often resemble bacterial profiles, while cultures can be falsely negative. Candida albicans is the most common species identified in post-surgical Candida meningitis, and delay in diagnosis and treatment can be devastating. The standard induction therapy for Candida meningitis has been amphotericin B combined with flucytosine. A high index of suspicion is needed in any patient with risk factors such as abdominal surgery, bowel perforation, recent broad spectrum antibiotic therapy, intravenous drug use, extremes of age, indwelling catheters, and immunosuppression such as Acquired Immune Deficiency Syndrome (AIDS), malignancy, antineoplastic therapy, and steroid use. Here, we describe three case presentations of patients with giant skull base tumors who developed post-surgical Candida meningitis, each with vastly different clinical courses and outcomes, ranging from benign to catastrophic. We performed a literature review with special focus on common risk factors, Candida species, diagnostic criteria, and treatment.

PMID: 28847554 [PubMed - as supplied by publisher]

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