The index case for the fungal meningitis outbreak in the United States.

Pettit AC, Kropski JA, Castilho JL, Schmitz JE, Rauch CA, Mobley BC, Wang XJ, Spires SS, Pugh ME
N Engl J Med. 2012 367 (22): 2119-25

PMID: 23083311 · DOI:10.1056/NEJMoa1212292

Persistent neutrophilic meningitis presents a diagnostic challenge, because the differential diagnosis is broad and includes atypical infectious causes. We describe a case of persistent neutrophilic meningitis due to Aspergillus fumigatus in an immunocompetent man who had no evidence of sinopulmonary or cutaneous disease. An epidural glucocorticoid injection was identified as a potential route of entry for this organism into the central nervous system, and the case was reported to the state health department.

MeSH Terms (21)

Aspergillosis Aspergillus fumigatus Brain Cerebellum Cerebral Infarction Cerebrospinal Fluid Diagnosis, Differential Disease Outbreaks Drug Contamination Fatal Outcome Glucocorticoids Headache Humans Injections, Epidural Intracranial Hemorrhages Low Back Pain Male Meningitis, Fungal Middle Aged Tomography, X-Ray Computed United States

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