Prospective study of nosocomial fungal Meningitis in children - Report of 10 Cases

Within an 8-year period, 10 cases of fungal nosocomial meningitis in childr en 0-13 y old mere prospectively identified, 3 caused by yeasts other than Candida spp. (Rhodotorula rubra, Aureobasidium mansoni, Clavispora lusitani ae) and 7 by Candida albicans. Seven patients survived, whereas 3 neonates with fungal meningitis (all due to C, albicans) died. Risk factors for fung al nosocomial meningitis included cancer (2 children), previous neurosurger y (2 children), cranial trauma (1 case) and prematurity with low birthweigh t (5 cases). All patients except 1 had received broad-spectrum antibiotics before onset of meningitis. In addition to yeasts, bacteria were isolated f rom CSF of 4 children. One child had additional fungaemia, Univariate analy sis was used to compare 10 cases of fungal to 91 cases of bacterial nosocom ial meningitis. Except for concurrent bacteraemia, (60 vs 25.3%, P < 0.03), which mas more frequently observed among fungal meningitis, there mere no significant differences in risk factors, sequelae or outcome (mortality) be tween patients with fungal vs bacterial meningitis. A review of fungal meni ngitis reported within the last 20 y is included.