Candida infection of the central nervous system following neurosurgery: a 12-year review.
Authors
O'Brien, DeirdreStevens, Niall T
Lim, Chor Hiang
O'Brien, Donncha F
Smyth, Edmond
Fitzpatrick, Fidelma
Humphreys, Hilary
Affiliation
Department of Clinical Microbiology, Beaumont Hospital, Dublin 9, Ireland., de.obrien@svuh.ieIssue Date
2012-02-01T10:00:08ZMeSH
AdolescentAdult
Aged
Antifungal Agents/therapeutic use
Brain Diseases/*surgery
Candidiasis/*diagnosis/drug therapy/*epidemiology/mortality
Cross-Sectional Studies
Female
Humans
Ireland
Male
Meningitis, Fungal/*diagnosis/drug therapy/*epidemiology/mortality
Middle Aged
Prostheses and Implants/microbiology
Retrospective Studies
Risk Factors
Surgical Wound Infection/*diagnosis/drug therapy/*epidemiology/mortality
Survival Analysis
Young Adult
Metadata
Show full item recordCitation
Acta Neurochir (Wien). 2011 Jun;153(6):1347-50. Epub 2011 Mar 23.Journal
Acta neurochirurgicaDOI
10.1007/s00701-011-0990-9PubMed ID
21431456Abstract
BACKGROUND: Candida infection of the central nervous system (CNS) following neurosurgery is relatively unusual but is associated with significant morbidity and mortality. We present our experience with this infection in adults and discuss clinical characteristics, treatment options, and outcome. METHODS: All episodes of Candida isolated from the central nervous system were identified by searching our laboratory database. Review of the cases was performed by means of a retrospective chart review. RESULTS: Eleven episodes of Candida CSF infection following neurosurgery were identified over a 12-year period. Candida albicans was the predominant species isolated (n = 8, 73%). All infections were associated with foreign intracranial material, nine with external ventricular drains (82%), one with a ventriculoperitoneal shunt, one with a lumbar drain, and one with Gliadel wafers (1,3-bis [2-chloroethyl]-1-nitrosurea). Fluconazole or liposomal amphotericin B were the most common anti-fungal agents used. The mortality rate identified in our series was 27%. CONCLUSIONS: Candida infection following neurosurgery remains a relatively rare occurrence but one that causes significant mortality. These are complex infections, the management of which benefits from a close liaison between the clinical microbiologist and neurosurgeon. Prompt initiation of antifungal agents and removal of infected devices offers the best hope of a cure.Language
engISSN
0942-0940 (Electronic)0001-6268 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1007/s00701-011-0990-9
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