Subba Sunu Hangma, Sharma Tara Devi, Dopthapa Yeshi Palden, Bhutia Ugen Gyatso N, Sharma Rekha
Department of Clinical Microbiology, Sir Thutob Namgyal Memorial Hospital, Sochakgang, Gangtok, India.
Department of Medicine, Sir Thutob Namgyal Memorial Hospital, Sochakgang, Gangtok, India.
Curr Med Mycol. 2024 May 7;10:e2024.345242.1542. doi: 10.22034/CMM.2024.345242.1542. eCollection 2024.
infections in India have shifted, with an increase in the incidence rate of invasive candidiasis, particularly due to non- species. The central nervous system infections by are sparsely reported and more understanding and research is needed regarding these infections.
This study reported an unusual case of meningitis in a middle-aged female with pulmonary tuberculosis and newly diagnosed acquired immunodeficiency syndrome with a low cluster of differentiation 4 count (12 cells/mm). Initially, the patient was treated with fluconazole. Subsequently, the patient underwent therapy involving amphotericin B and flucytosine. The cerebrospinal fluid cultures eventually grew , confirmed by matrix-assisted laser desorption ionization time-of-flight analysis. Despite switching to amphotericin B and flucytosine, the conditions of the patient deteriorated, leading to her death.
candidemia requires meticulous and vigilant management due to its high mortality rate and relatively higher resistance to azoles, particularly fluconazole. This case underscored the severe and pressing challenges in the management of meningitis, particularly in immunocompromised patients.
印度的感染情况已发生转变，侵袭性念珠菌病的发病率有所上升，尤其是由非特定菌种引起的。关于其引起的中枢神经系统感染的报道较少，需要对这些感染进行更多的了解和研究。
本研究报告了一例不寻常的病例，一名患有肺结核和新诊断的获得性免疫缺陷综合征且分化簇4计数较低（12个细胞/mm³）的中年女性发生了念珠菌性脑膜炎。最初，患者接受氟康唑治疗。随后，患者接受了两性霉素B和氟胞嘧啶的治疗。脑脊液培养最终培养出念珠菌，通过基质辅助激光解吸电离飞行时间分析得以确认。尽管改用了两性霉素B和氟胞嘧啶，但患者的病情仍恶化，最终死亡。
念珠菌血症因其高死亡率和对唑类药物（尤其是氟康唑）相对较高的耐药性，需要进行细致且警惕的管理。该病例凸显了念珠菌性脑膜炎管理中严峻且紧迫的挑战，尤其是在免疫功能低下的患者中。
