ISSN - 0973-0958

Pediatric Oncall Journal View Article

Candida Meningitis Resulting from Cribriform Plate Damage Following Head Injury
Karuna Thapar, Naresh Jindal, Gaurav Dhawan, Ira Dhawan.
Department of Pediatrics, Government Medical College, Amritsar, India.
A 16 year old female presented to us with a 15 days history of headache, stiff neck, fever and vomiting. On general physical examination, patient was lethargic and irritable. She was a known case of recurrent meningitis following a head injury at age of 2 years. Since then, she had got 10 episodes of meningitis. She was treated for pyogenic meningitis at our centre 3 years back when a MRI scan was done. It showed a rent in cribriform plate in the middle third on right side with CSF leak. ELISA for HIV was negative. A CSF examination was showing a lymphocytic pleocytosis (total cells 325 with 90% lymphocytes), a reduced glucose level (34 mg %) and an elevated protein level (185 mg %). A gram-stained smear revealed budding yeast cells suggesting Candida albicans. Bacterial cultures were negative. A diagnosis of Candida meningitis was established and child was put on IV Fluconazole to which she showed good response and the therapy was continued for 4 weeks.

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