Invasive Candida Meningitis in an Immunocompetent Neurosurgical Patient: A Rare Case Report of Post-Traumatic Complication

Nabamita Bhaumik; Laya Mahadevan; Subbalakshmi  Easwaran

Nabamita Bhaumik Postgraduate Student, Department of Clinical Microbiology, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
Laya Mahadevan Professor, Department of Critical Medicine, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
Subbalakshmi Easwaran Professor, Department of Clinical Microbiology, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India

Keywords: Candida meningitis, Fungal meningitis, Candida albicans, Post-traumatic infective meningitis, antifungals

Abstract

Candida meningitis is a rare but serious central nervous system infection, primarily affecting neurosurgical patients with indwelling devices. It mimics symptoms similar to bacterial or tuberculous meningitis, complicating early diagnosis. We report the case of a 32-year-old male who developed Candida albicans meningitis following ventriculoperitoneal (VP) shunt placement after decompressive craniotomy for traumatic brain injury. Cerebrospinal fluid (CSF) analysis showed pleocytosis, elevated protein, and markedly low glucose levels. Fungal cultures grew Candida albicans, confirmed by the VITEK 2 Compact system, with antifungal susceptibility to amphotericin B, fluconazole, and echinocandins. The patient was started on liposomal amphotericin B and fluconazole, achieving transient clinical improvement; however, he subsequently developed septic shock and succumbed despite intensive management. This case emphasises the rarity of Candida meningitis, the diagnostic difficulties it presents, and the importance of early antifungal therapy and device removal in improving outcomes.

How to cite this article:
Bhaumik N, Easwaran S, Mahadevan L. Invasive Candida Meningitis in an Immunocompetent Neurosurgical Patient: A Rare Case Report of Post-Traumatic Complication. J Commun Dis. 2026;58(1):168-173.

DOI: https://doi.org/10.24321/0019.5138.202610

Author Biographies

Laya Mahadevan, Professor, Department of Critical Medicine, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India

Associate Professor, Department of Critical Medicine

Subbalakshmi Easwaran, Professor, Department of Clinical Microbiology, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India

Professor, Department of Microbiology

References

Fong, Ignatius W. Current trends and concerns in infectious diseases. No. 181032. Berlin/Heidelberg,

Germany: Springer, 2020

Chen M, Chen C, Yang Q, Zhan R. Candida meningitis in neurosurgical patients: a single-institute study of

nine cases over 7 years. Epidemiol Infect. 2020 May 22;148:e148. [PubMed] [Google Scholar]

Gottfredsson M, Perfect JR. Fungal meningitis. Semin Neurol. 2000;20(3):307-22. [PubMed] [Google Scholar]

Greenlee JE. Approach to diagnosis of meningitis. Cerebrospinal fluid evaluation. Infect Dis Clin North Am. 1990 Dec;4(4):583-98. [PubMed] [Google Scholar]

Bridges KJ, Li R, Fleseriu M, Cetas JS. Candida meningitis after transsphenoidal surgery: a single-institution case

series and literature review. World Neurosurg. 2017 Dec;108:41-9. [PubMed] [Google Scholar]