Candida Meningitis After Transsphenoidal Surgery

A Single-Institution Case Series and Literature Review

Kelly J. Bridges, Ryan Li, Maria Fleseriu, Justin Cetas

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Candida meningitis after 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, and cultures can be falsely negative. Candida albicans is the most common species identified in postsurgical 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 AIDS, malignancy, antineoplastic therapy, and steroid use. Here, we describe 3 case presentations of patients with giant skull base tumors who developed postsurgical 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.

Original languageEnglish (US)
Pages (from-to)41-49
Number of pages9
JournalWorld Neurosurgery
Volume108
DOIs
StatePublished - Dec 1 2017

Fingerprint

Candida
Meningitis
Neurosurgical Procedures
Flucytosine
Indwelling Catheters
Skull Base
Amphotericin B
Therapeutics
Candida albicans
Antineoplastic Agents
Immunosuppression
Cerebrospinal Fluid
Neoplasms
Acquired Immunodeficiency Syndrome
Steroids
Anti-Bacterial Agents
Drug Therapy

Keywords

  • Candida
  • Meningioma
  • Meningitis
  • Pituitary adenoma
  • Skull base surgery
  • Transnasal
  • Transsphenoidal
  • Vasospasm

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Candida Meningitis After Transsphenoidal Surgery : A Single-Institution Case Series and Literature Review. / Bridges, Kelly J.; Li, Ryan; Fleseriu, Maria; Cetas, Justin.

In: World Neurosurgery, Vol. 108, 01.12.2017, p. 41-49.

Research output: Contribution to journalArticle

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