Candidal menengitis in a case of acute lymphoblastic leukemia

Fungal infections have become a leading cause of morbidity and mortality in cancer patients. One particular problem in the management of these infections is the diffuculty in early diagnosis and delay in specific treatment.

A candidal meningitis case has been presented in a patient who was hospitalized with acute lymphoblastic leukaemia diagnosis in SSK Göztepe Training Hospital Paediatrics Clinic Haematology-Oncology Deparment. A 4 year old girl developed neutropenia in the 23th day of chemotherapy. She was receiving TRALL-BFM 2000 protocoll. Following neutropenia she had fever, abdominal pain and anorexia. Candida parapsilosis was found in cerebrospinal fluid culture. She had been given conventional Amphotericin B according to the antibiogram but fever persisted. Then the drug was changed to liposomal Amphotericin B. Clinical and laboratory recovery was seen after liposomal Amphotericin B.

In oncology patients candidal infections must be considered due to abundance of risk factors and contamination routes. In high risk neutropenik patients antifungal therapy must begun not later than 7th day of fever. Therapy should be changed to liposomal Amphoterecin B in the case of irresponsiveness to conventional Amphoterecin B therapy because of the probability of resistant candidiasis.

Akut lenfoblastik lösemi olgusunda geliþen kandida menenjiti