Use of Cerebrospinal Fluid (1,3)-β-d-Glucan to Monitor Treatment Response in Candida albicans Meningitis in an HIV-infected Patient

Abstract

Abstract Candida meningitis is rare in the setting of human immunodeficiency virus (HIV) infection and often presents a diagnostic challenge. Its clinical features typically mimic those of cryptococcal or tuberculous meningitis and Candida can be difficult to culture from cerebrospinal fluid. Furthermore, optimal treatment and monitoring parameters are not well defined. Cerebrospinal fluid levels of (1,3)-β-d-glucan, which is a component of the fungal cell wall, have been used to diagnose and monitor response to therapy in other cases of fungal meningitis, but its utility in the setting of Candida meningitis and HIV infection is less clear. Here, we present a case of spontaneous Candida albicans meningitis in a woman with advanced HIV infection and report on the clinical utility of cerebrospinal fluid (1,3)-β-d-glucan for diagnosis and monitoring of chronic infection.