Journal article
Intradural cauda equina Candida abscess presenting with hydrocephalus: case report
Journal of neurosurgery. Spine, v 31(6), pp 890-893
01 Dec 2019
PMID: 31470401
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Central nervous system (CNS) candida infections are often associated with a poor prognosis. Typically, CNS candidiasis presents as meningitis or microabscesses. Here, the authors report a patient with a challenging presentation of a CNS Candida infection as a discrete, large cauda equina abscess. The patient initially presented with ventriculomegaly due to fourth ventricular outflow obstruction and a cauda equina mass. The patient was treated with a ventriculoperitoneal shunt and underwent a lumbar laminectomy for exploration of the lumbar lesion. An intradural abscess was encountered during surgery. Fungal wet mount revealed fungal elements and polymerase chain reaction confirmed the presence of Candida albicans. The patient did not have any known predisposition to fungal infections; therefore, the authors performed whole-exome sequencing using peripheral blood mononuclear cell DNA. They found heterozygous missense variants in the following genes: colony-stimulating factor 2 (CSF2) and Ras protein-specific guanine nucleotide-releasing factor 1 (RAS-GRF1)-genes that have been specifically associated with protection from CNS candidiasis via caspase recruitment domain-containing protein 9 (CARD9) signaling, and phospholipase C gamma 2 (PLCG2)-a lectin receptor involved in candidiasis. The authors' experience suggests that C. albicans can present as a cauda equina abscess. Hydrocephalus, a result of diffuse arachnoiditis, is a potential complication from intradural fungal abscesses.
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Details
- Title
- Intradural cauda equina Candida abscess presenting with hydrocephalus: case report
- Creators
- Davis P. Argersinger - National Institute of Neurological Disorders and StrokeVitaliy P. Natkha - Texas Tech UniversityMatthew J. Shepard - Neurological SurgeryAlissa A. Thomas - University of Vermont Medical CenterAndrew J. Oler - Naval Research Laboratory Information Technology DivisionPeter R. Williamson - National Institute of Allergy and Infectious DiseasesPrashant Chittiboina - National Institute of Neurological Disorders and StrokeJohn D. Heiss - National Institute of Neurological Disorders and Stroke
- Publication Details
- Journal of neurosurgery. Spine, v 31(6), pp 890-893
- Publisher
- Amer Assoc Neurological Surgeons
- Number of pages
- 4
- Grant note
- National Institute of Allergy and Infectious Disease, National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID) National Institute of Neurological Disorders and Stroke; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:000500259800015
- Scopus ID
- 2-s2.0-85076361151
- Other Identifier
- 991022155295304721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery