MARKED POLYMORPHONUCLEAR PLEOCYTOSIS DUE TO BLASTOMYCOTIC MENINGITIS - CASE-REPORT AND REVIEW

Meningitis is an unusual manifestation of infection caused by Blastomy ces dermatitidis. We describe a patient who presented with fulminant b lastomycotic meningitis. Examination of the lumbar CSF demonstrated > 5,000 polymorphonuclear leukocytes/mm(3). The diagnosis of B. dermatit idis meningitis was initially suggested by cytologic examination of CS F and confirmed by culture. Pleocytosis of this magnitude had not been previously described in association with blastomycosis, although revi ew of the published literature revealed that neutrophilic pleocytosis is a common manifestation of blastomycotic meningitis and should sugge st the diagnosis. This report broadens the clinical spectrum of blasto mycotic meningitis and suggests that cytologic examination of CSF is a useful way to establish this diagnosis.