1/64. Liposomal amphotericin b in neonates with invasive candidiasis.Liposomal amphotericin b (L-Amp B), a novel formulation of amphotericin b, is effective for the treatment of invasive fungal infections in children and adults and is associated with less toxicity than the conventional preparation. Data on the use of Liposomal amphotericin b in neonates is scarce. We describe the clinical course of two premature infants who were treated with Liposomal amphotericin b (one infant had candidemia, and the other had candidemia and meningitis), and provide a summary of previously published experience on this topic. Liposomal amphotericin b may be an option for therapy of invasive candidiasis in neonates who are at high risk of nephrotoxicity and other amphotericin-related reactions, but clinical trials are necessary to document its safety and efficacy in this age group.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
2/64. candida albicans meningitis: clinical case.Candida spp. meningitis is still a rare clinical situation, although it is becoming more frequent. literature references to it and therapeutic options are scarce. We present a case of a young male, hiv-positive drug addict, with candida albicans meningitis which was treated with oral fluconazole, having a good outcome.- - - - - - - - - - ranking = 6keywords = meningitis (Clic here for more details about this article) |
3/64. Candida lusitaniae infections in the era of fluconazole availability.amphotericin b resistance among isolates of Candida lusitaniae has distinguished it among Candida species. Because no comprehensive review has been published recently, we provide a case report and a literature review of C. lusitaniae infection to update and better characterize the illness in the era of azole availability and standardized methodologies for antifungal susceptibility testing. C. lusitaniae infection in the 55 cases surveyed in this review occurred in relatively young patients (median age, 44 years). fungemia was found in 80% of patients. Other infection syndromes, including peritonitis, meningitis, and urinary tract infection, were much less common. Three-fourths of the patients had serious underlying medical conditions. Despite the presence of fungemia and predisposing comorbidities, death due to C. lusitaniae infection was uncommon among treated patients (5.00%). Moreover, in vitro susceptibility testing results for amphotericin b did not appear to predict patient outcome in this survey.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
4/64. glioblastoma, transforming growth factor-beta, and Candida meningitis: a potential link.The development of Candida meningitis in a patient following partial resection of a glioblastoma raised suspicion that transforming growth factor (TGF-beta), an immunosuppressive cytokine known to be produced by this tumor, would be elevated in his cerebrospinal fluid (CSF). By using a highly specific bioassay, the concentration of TGF-beta was found to be 609 pg/mL, which was 10-fold greater than the mean CSF TGF-beta value in control subjects with no neurologic disease. Increased CSF TGF-beta levels were also detected in patients with other central nervous system (CNS) diseases: malignancies and aids dementia complex. These findings suggest that TGF-beta may play an immunopathogenetic role in the CNS.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
5/64. candida tropicalis meningitis in a young infant.candida tropicalis is a rare species of Candida causing meningitis. The authors report a young infant who developed candida tropicalis meningitis following a prolonged stay in a neonatal intensive care unit for respiratory distress and intra-cranial hemorrhage. The child was successfully treated with recommended doses of amphotericin b and 5-flucytosine for eight weeks.- - - - - - - - - - ranking = 6keywords = meningitis (Clic here for more details about this article) |
6/64. Detection of the Candida antigen mannan in cerebrospinal fluid specimens from patients suspected of having Candida meningitis.cerebrospinal fluid samples from five patients from which Candida cells were cultured were tested for the presence of mannan. Samples from four patients categorized as having proven candidosis reacted positively. Samples from the remaining patient and from patients with other central nervous system infections were negative. Detection of mannan may be valuable in the diagnosis of Candida meningitis.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
7/64. Candidal meningitis in hiv-infected patients.Candida meningitis is considered a rare event in hiv-infected patients, and little is known about risk factors, clinical presentation, therapy of choice, or outcome in this population. In a review of 14 cases, we observed a low frequency of the disease, a strong association to other well-known risk factors for systematic candidiasis, such as intravenous drug use, and a chronic course and clinical features that mimic those of cryptococcal or tuberculous meningitis. Although the role of fluconazole treatment remains to be defined, the combination of amphotericin b with flucytosine offers a survival rate similar to non-hiv-infected patients. In addition, the use of suppressive therapy with fluconazole for a prolonged period after clinical improvement seems recommendable.- - - - - - - - - - ranking = 6keywords = meningitis (Clic here for more details about this article) |
8/64. Lethal otogenic Candida meningitis.history revealed a chronic obstructive pulmonary condition which had been treated with prednisolone for a long time. There was a raised temperature with further signs of an acute inflammatory underlying disease and internal hydrocephalus. After performing trepanation, the symptoms of raised intercerebral pressure ceased. candida albicans could be detected microbiologically in the cerebrospinal fluid. There was no pneumonia at the time of admission. Despite instituting immediate intensive care with administration of antibiotics and antimycotics, the patient died 11 days after inpatient admission. autopsy revealed a C. albicans mycosis originating from the right middle ear with extensive suppurative meningitis, which was the immediate cause of death. Confluent bronchopneumonia had developed in both lower lung lobes at the time of death, but did not show any signs of mycosis and had contributed indirectly to the death of the patient.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
9/64. Refractory candidal meningitis in an immunocompromised patient cured by caspofungin.Candidal meningitis is a rare infectious disease that usually leads to substantial morbidity and mortality. We present a case of candidal meningitis refractory to systemic antifungal therapy (amphotericin b and fluconazole). A 63-year-old female with lymphoblastic lymphoma and myelodysplasia with leukemia transformation developed prolonged fever and headache on the seventh day following intrathecal prophylactic chemotherapy. A lumbar puncture showed neutrophilic pleocytosis, and a cerebrospinal fluid culture yielded candida albicans. The clinical course was complicated by brain edema, subarachnoid hemorrhage, and hydrocephalus. Parenteral therapy with amphotericin b alone or amphotericin b in combination with fluconazole or intrathecal administration of amphotericin b failed to eradicate C. albicans in the cerebrospinal fluid. After 7 days of caspofungin therapy, however, the cerebrospinal fluid became sterile and the patient gradually regained consciousness. She was discharged 1 month after completing 4 weeks of caspofungin therapy. There were two critical issues we thought to be relevant to the favorable outcome of this case. First, isolation of C. albicans was achieved by inoculating enriched liquid medium with cerebrospinal fluid. Second, there is a potential therapeutic benefit of caspofungin in treating a fungal infection of the central nervous system.- - - - - - - - - - ranking = 6keywords = meningitis (Clic here for more details about this article) |
10/64. Recurrent candida tropicalis meningitis.Candida meningitis, a previously rare occurrence, has been increasing in prevalence and often is a result of complications of neurosurgery. We describe the case of a 49-year-old man who presented with headache, vertigo, intermittent blurred vision, and multiple episodes of nausea and vomiting. Computed tomography (CT) showed a left cerebellar hemorrhage with obliteration of the fourth ventricle causing hydrocephalus. He had an occipital craniotomy with transcondylar evacuation of the hemorrhage and placement of a temporary ventriculostomy. The hospital stay was prolonged because of postsurgical complications, and candida tropicalis meningitis developed. Treatment was started with 400 mg of fluconazole administered intravenously every 12 h. in vitro susceptibility testing showed a minimum inhibitory concentration (MIC) to fluconazole of 1 microg/mL. fluconazole was therefore continued orally for a total of 60 days, and the patient remained asymptomatic for 2 years. He then presented with increased vertigo and ataxia. cerebrospinal fluid cultures grew C. tropicalis, which again showed susceptibility to fluconazole with a MIC of 1 microg/mL, identical to that in the previous infection. However, a second course of fluconazole failed to control the infection despite adequate cerebrospinal fluid levels.- - - - - - - - - - ranking = 6keywords = meningitis (Clic here for more details about this article) |
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