Mould meningitis associated with intravenous drug use

Hassan Shah; Stephen Honeybul; Stephanie Tang; Ian Arthur; Sally McLaren; Peter Boan

doi:10.1016/j.mmcr.2018.01.004

Mould meningitis associated with intravenous drug use

Med Mycol Case Rep. 2018 Jan 10:20:18-20. doi: 10.1016/j.mmcr.2018.01.004. eCollection 2018 Jun.

Authors

Hassan Shah¹, Stephen Honeybul², Stephanie Tang¹, Ian Arthur³, Sally McLaren⁴, Peter Boan⁵

Affiliations

¹ Department of Rehabilitation Medicine, Fiona Stanley Hospital, Perth, Western Australia, Australia.
² Department of Neurosurgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
³ PathWest Laboratory Medicine WA, Department of Microbiology, QEII Medical Centre, Perth, Western Australia, Australia.
⁴ PathWest Laboratory Medicine WA, Department of Anatomical Pathology, QEII Medical Centre, Perth, Western Australia, Australia.
⁵ Departments of Infectious Diseases and Microbiology, Fiona Stanley Hospital and PathWest Laboratory Medicine WA, Perth, Western Australia, Australia.

Abstract

Fungal meningitis is most commonly causes by Cryptococcus species and dimorphic fungi. We present a rare case of mould meningitis, ventriculitis and subependymal nodules in an immunocompetent patient, having likely seeded the meninges and ventricular system through intravenous drug use. The causative mould remains undetermined. The case highlights the poor sensitivity of CSF culture and the need to consider surgical biopsy where there is diagnostic difficulty and fungal infection is being considered.

Keywords: Fungal meningitis; IVDU; Intravenous drug use; Pithomyces.