Abstract
A 76-year-old man with headache had taken oral analgesics for 2 months. On his date of admission, his consciousness rapidly deteriorated, and he was transported to the emergency room. A head CT scan showed inflammatory changes in the sphenoid sinus with bone erosion, and an MRI showed a subdural abscess mainly located in the posterior fossa. Based on blood serum and cerebrospinal fluid（CSF）tests, the patient was initially diagnosed with bacterial meningitis, and broad-spectrum antibacterial drugs were administered. Despite the antibiotics, his meningitis progressively worsened, and he died on the second day of hospitalization. Although his blood and CSF cultures were negative, Candida Albicans was identified in the culture from the sphenoid sinus mucosa. Ultimately, he was diagnosed with fungal meningitis pursuant to chronic sinusitis. Fungal meningitis should be suspected when paranasal sinusitis is present. Rapid diagnosis and early initiation of antifungal drugs may improve outcome.
