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Chronic Candidal Meningitis: An Uncommon Manifestation of Candidiasis
Clin Inf Dis 19:60-66, Voice, R.A.,et al, 1994
See this aricle in Pubmed

Article Abstract
Chronic meningitis is an uncommon manifestation of candidiasis. We present the case of an elderly woman who had symptoms such as headache, malaise, and fever for 8 months and was found to have Candida albicans meningitis, and we review 17 similar cases. An underlying illness or risk factor for candidiasis was present in only 13 (72%) of the 18 patients. Headache, fever and nuchal rigidity were the predominant clinical findings. Analysis of CSF showed either mononuclear or neutrophilic pleocytosis, an elevated protein level, and a decreased level of glucose. Only 17% of CSF smears were positive, and only 44% of initial CSF cultures yielded Candida species. In four cases, Candida species grew only after special techniques were used; in three cases, CSF cultures remained negative. The overall mortality associated with candida meningitis was 53%, but among 12 patients who were treated and followed, the rate was 33%. In addition to acute meningitis seen with disseminated infection, Candida species can cause chronic meningitis that mimics tuberculosis and the more common fungal meningitides, such as cryptococcosis.
 
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cerebrospinal fluid,abnormal
differential diagnosis
fever
headache
hydrocephalus
hypoglycorrhachia
immunosuppression
intravenous drug abuse
meningismus
meningitis
meningitis,adults
meningitis,candida
meningitis,chronic
meningitis,fungal-negative CSF culture
meningitis,spinal fluid smear and culture-negative
mimics
mortality
pleocytosis of cerebrospinal fluid
prognosis
risk factors

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