Case Report: Candida dubliniensis as a Cause of Chronic Meningitis.
Case Report: Candida dubliniensis as a Cause of Chronic Meningitis.
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DOI：
10.3389/fneur.2020.601242
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发表时间：
2020
影响因子：
3.4
通讯作者：
Jordan SJ
中科院分区：
文献类型：
--
作者：
Tahir M;Peseski AM;Jordan SJ
背景：都柏林念珠菌与白色念珠菌关系密切，临床分离株较少。C. Dubliniensis越来越被认为是免疫受损宿主中的病原体。我们提出了第三个已知的情况下，念珠菌都柏林脑膜炎在一个年轻的免疫活性主机。病例介绍：一名27岁女性，有静脉注射海洛因和慢性丙型肝炎病史，有10个月头痛和进行性双侧视力丧失病史。体检时，她的右眼视力为20/20，并出现II级视乳头水肿。左眼检查显示视力完全丧失和IV级视乳头水肿。磁振造影及非磁振造影显示后颅窝及脊髓的软脑膜强化增加。多次腰椎穿刺后，脑脊液真菌培养生长都柏林念珠菌。该患者成功地接受了脂质体阿替霉素和氟康唑联合治疗6周，除不可逆的视力丧失外，其CNS症状完全消退。结论：我们报告一例慢性脑膜炎由于念珠菌都柏林在免疫功能正常的妇女与丙型肝炎和历史的静脉注射海洛因使用。需要进一步的研究来确认都柏林念珠菌定植的危险因素，这可能使个体易患侵袭性念珠菌病。
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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