AETC National Resource Center


	participating institutions: Johns Hopkins University AIDS Service, New York State DOH AIDS Institute, The CORE Center, Cook County Hospital

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Invasive Fungal Sinusitis and Meningitis Due to Arthrographis kalrae in a Patient with AIDS [Chin-Hong PV, et al. JCM 2001;39:804]: This is a case report of pansinusitis and meningitis in a patient with AIDS. Endoscopic biopsy and culture yielded Arthrographis kalrae. The patient was treated with itraconazole for five months and eventually died of PCP. Autopsy indicated fungal invasion of the sphenoid sinuses that extended through the cribiform plate.
Comment: A. kalrae is a soil fungus that has only rarely been implicated as a human pathogen. AIDS patients get sinusitis more frequently compared to immunocompetent hosts. The predominant pathogens are those from the traditional list: S. pneumoniae and H. influenzae, with a smattering due to M. catarrhalis, S. aureus, P. aeruginosa, and other Gram-negative bacteria. A recent review of invasive fungal infections showed that these were usually found with a CD4 cell count <150/mm³ [CID 1999;29:212]. This report included a review of 25 cases in AIDS patients, including 19 caused by Aspergillus. Management guidelines are controversial.
posted 2/22/2001

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