A 7-Year-Old Child With Headaches and Prolonged Fever Associated With Oral and Nail Lesions.

Abstract:

:A 7-year-old child of Turkish origin presented with headache and vomiting in the context of prolonged fever of unknown source. At examination, oral candidiasis and chronic onychomycosis were noted. A Candida meningoencephalitis was diagnosed and intravenous Amphotericin B liposomal was given during 6 months relayed by oral Fluconazole after regression of CNS lesions was observed on MRI. A complete immune evaluation was performed, and genetic analysis detected homozygous CARD9 mutation. CARD9 deficiency have been associated with invasive candidiasis in otherwise healthy patients. Culture of the cerebrospinal fluid grew for multisensitive Candida albicans. Brain magnetic resonance (MRI) showed the presence of focal lesions in the left caudate nucleus and in the right cerebellar hemisphere. Medullar MRI showed diffuse meningeal nodular lesions. Treatment with intravenous amphotericin B liposomal was given during 6 months relayed by oral fluconazole after regression of CNS lesions was observed on MRI. A complete immune evaluation was performed and genetic analysis detected a homozygous CARD9 mutation. CARD9 deficiency have been associated with invasive candidiasis in otherwise healthy patients.

journal_name

Open Forum Infect Dis

authors

Martin S,Balligand E,Peeters J,Nassogne MC,Mondovits B,Loop M,de Selys A,Vanclaire J,Vermylen C,De Bruyckere JJ,Chatzis O,Puel A,Gilliaux O,Van Der Linden D

doi

10.1093/ofid/ofz229

subject

Has Abstract

pub_date

2019-11-03 00:00:00

pages

ofz229

issue

11

issn

2328-8957

pii

ofz229

journal_volume

6

pub_type

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