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“Unexplained” Delayed Death From Fungal Meningitis After Meningioma Resection

Published online by Cambridge University Press:  18 September 2015

R. John Hurlbert ,
Juan M. Bilbao  and
William S. Tucker
R. John Hurlbert
Affiliation:
Division of Neurosurgery and the Department of Pathology, St. Michael’s Hospital, Toronto
Juan M. Bilbao
Affiliation:
Division of Neurosurgery and the Department of Pathology, St. Michael’s Hospital, Toronto
William S. Tucker*
Affiliation:
Division of Neurosurgery and the Department of Pathology, St. Michael’s Hospital, Toronto
*
Chief of Neurosurgery, St. Michael’s Hospital, 38 Shuter St., Toronto, Ontario, Canada M5B IA6
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Abstract

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Background

Progressive deterioration and ensuing death following a neurosurgical procedure often represents a diagnostic challenge to the team responsible for patient care. Many, but not all, causes are treatable if a diagnosis is made early.

Methods

A 69-year-old woman who died 6 weeks post-operatively following a meningioma resection is reported. An initial routine post-operative course became complicated by progressive neurological deterioration 3–4 weeks later. Despite extensive investigation she died 6 weeks post-operatively without a diagnosis.

Results

Autopsy demonstrated extensive Candida meningitis. A review of the literature demonstrates this to be a reported complication in high risk patients, difficult to diagnose, but treatable when identified.

Conclusions

Fungal meningitis should be high in the differential diagnosis in the post-operative patient with delayed, unexplained neurological deterioration, especially when associated with negative CSF cultures.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 22 , Issue 3 , August 1995 , pp. 239 - 243
Copyright
Copyright © Canadian Neurological Sciences Federation 1995

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