Candida meningitis in a paediatric aids patient – a case report

Abstract

Background: The impact of HIV/AIDS epidemic in the health of children in sub-Saharan Africa has been severe. Children with advance HIV infection are vulnerable to infections because of the weakened immune system and Fungal infection is a common opportunistic infection in people living with HIV. CASE REPORT: A 10year old boy presented to a private health facility in Kano (north-west Nigeria, Medicus Clinic) with history of fever for five days and convulsions for three days. The convulsion was described as generalized and tonic with post-ictal loss of consciousness. There was no associated sphincteric impairment. He had about twelve episodes before presentation. On examination, he was pale and febrile (temp – 39oC), and had oral thrush. There were cervical lymph nodes enlargements. He was unconscious with Glasgow coma score of 6/15. The pulse rate was 110 beats per minutes; blood pressure was 100/60mmHg. Neurologic examination revealed neck stiffness, positive Kerning's and Brudzuski's signs suggestive of menigeal inflammation. Conclusions: Fungal culture should be initiated in HIV patients presenting with meningitis whose CSF analysis does not support bacterial aetiology. Prompt diagnosis of fungal meningitis is important because it gives a necessary guide and adjustment in chemotherapy thus preventing associated complications.