Chronic meningitis by Acremonium sp.

Abstract

Acremonium sp are rarely described as opportunistic pathogens in humans. This case report presents chronic meningitis caused by Acremonium sp. Woman, 56 years old, with fever, headaches in the frontal region of the face, irradiating to the nape, over a four-month period. When the patient was admitted in Hospital de Base, showed edema of the left papilla and was directed to the neurologist, because of the clinical suspicions of bacterial meningitis. Four samples of cerebrospinal fluid (CFS) were collected during the hospital stay, but the presence of bacteria was not detected. However, due to the increase of celularity of CFS, the antibiotic therapy was introduced. Considering the decline of the general state, in the 26th day, the sphenoidectomy was realized with functional endoscope sinus surgery apart from the collection of secretion. Its macroscopic aspect suggested fungal disease, when than was introduced amphotericin B as treatment. The culture of secretion revealed the presence of Acremonium sp. In the 28th day, was required new sample of the CFS, where was isolated Acremonium sp. At this time, the patient presented convulsions and died. This report highlights the importance of investigations for uncommon microorganisms in patients without risk factors, and the necessity of diagnosis for early adoption of specific treatment against such agents, in order to reduce morbidity and mortality.