Fungal infection associated with intravenous drug abuse: a case of localized cerebral phycomycosis.

The authors present a case of confusion and mood disturbance caused by a focal cerebral fungal (phycomycosis) infection in an otherwise healthy intravenous drug addict. A review of the literature found only 9 cases of phycomycosis with localized cerebral involvement. This report describes the sixth occurrence of phycomycosis in an intravenous drug addict (the fifth to localize in the basal ganglia). In addition to the human immunodeficiency virus, unusual infectious causes of confusion and mood disturbance may be increasing as the intravenous drug-using population expands. Recognition of the clinical features of a fungal infection in a high-risk population may lead to earlier diagnosis and more effective treatment of this uniformly fatal disease. The clinician should consider localized cerebral phycomycosis as a cause of confusion and mood disturbance in intravenous drug addicts, especially when there is evidence of basal ganglia involvement.