Candida infection of the central nervous system following neurosurgery: a 12-year review.

Hdl Handle:
http://hdl.handle.net/10147/207137
Title:
Candida infection of the central nervous system following neurosurgery: a 12-year review.
Authors:
O'Brien, Deirdre; Stevens, 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.ie
Citation:
Acta Neurochir (Wien). 2011 Jun;153(6):1347-50. Epub 2011 Mar 23.
Journal:
Acta neurochirurgica
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207137
DOI:
10.1007/s00701-011-0990-9
PubMed ID:
21431456
Abstract:
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:
eng
MeSH:
Adolescent; Adult; 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
ISSN:
0942-0940 (Electronic); 0001-6268 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorO'Brien, Deirdreen_GB
dc.contributor.authorStevens, Niall Ten_GB
dc.contributor.authorLim, Chor Hiangen_GB
dc.contributor.authorO'Brien, Donncha Fen_GB
dc.contributor.authorSmyth, Edmonden_GB
dc.contributor.authorFitzpatrick, Fidelmaen_GB
dc.contributor.authorHumphreys, Hilaryen_GB
dc.date.accessioned2012-02-01T10:00:08Z-
dc.date.available2012-02-01T10:00:08Z-
dc.date.issued2012-02-01T10:00:08Z-
dc.identifier.citationActa Neurochir (Wien). 2011 Jun;153(6):1347-50. Epub 2011 Mar 23.en_GB
dc.identifier.issn0942-0940 (Electronic)en_GB
dc.identifier.issn0001-6268 (Linking)en_GB
dc.identifier.pmid21431456en_GB
dc.identifier.doi10.1007/s00701-011-0990-9en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207137-
dc.description.abstractBACKGROUND: 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.en_GB
dc.language.isoengen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshAntifungal Agents/therapeutic useen_GB
dc.subject.meshBrain Diseases/*surgeryen_GB
dc.subject.meshCandidiasis/*diagnosis/drug therapy/*epidemiology/mortalityen_GB
dc.subject.meshCross-Sectional Studiesen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIrelanden_GB
dc.subject.meshMaleen_GB
dc.subject.meshMeningitis, Fungal/*diagnosis/drug therapy/*epidemiology/mortalityen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshProstheses and Implants/microbiologyen_GB
dc.subject.meshRetrospective Studiesen_GB
dc.subject.meshRisk Factorsen_GB
dc.subject.meshSurgical Wound Infection/*diagnosis/drug therapy/*epidemiology/mortalityen_GB
dc.subject.meshSurvival Analysisen_GB
dc.subject.meshYoung Adulten_GB
dc.titleCandida infection of the central nervous system following neurosurgery: a 12-year review.en_GB
dc.contributor.departmentDepartment of Clinical Microbiology, Beaumont Hospital, Dublin 9, Ireland., de.obrien@svuh.ieen_GB
dc.identifier.journalActa neurochirurgicaen_GB
dc.description.provinceLeinster-

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