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General Rehabilitation

Candida lusitaniae meningitis in an immunocompetent male after severe penetrating traumatic brain injury: A Case Report

Friday, October 24, 2025
12:00 PM - 1:30 PM MT
Location: Kiosk 1
Has Audio

    Poster Presenter(s)

  • Christian Wirawan, DO

    Resident
    Schwab Rehabilitation/University of Chicago
    Chicago, Illinois

    • Co-Author(s)

  • ER

    Eraad Rahman, MS

    Medical Student
    Midwestern University Chicago College of Osteopathic Medicine
    Woodridge, Illinois

  • CB

    Cheryl Benjamin, DO

    Associate Program Director
    Schwab Rehabilitation Hospital & Care Network/University of Chicago PM&R Program
    Skokie, Illinois

Disclosure(s):
Christian Wirawan, DO: No financial relationships to disclose
Eraad Rahman, MS: No financial relationships to disclose
Case Diagnosis: 30-year-old male presenting with Traumatic Brain Injury (TBI) due to 2 gunshot wounds (GSW), complicated by Candida lusitaniae fungal meningitis.

Case Description or Program Description: 30-year-old immunocompetent male who presented with severe penetrating TBI and multifocal hemorrhage due to 2 GSWs to the head. His 3-month hospital course was complicated by bilateral posterior cerebellar artery infarcts, pseudoaneurysm, cerebrospinal fluid leaks (CSF) from both wound sites, pseudo meningocele, and presumed bacterial meningitis. However, the patient continued to have recurrent fevers with repeat lumbar punctures showing high white blood cell count and decreased glucose levels, despite two weeks of vancomycin and cefepime. One month after admission, fungal culture demonstrated Candida Lusitaniae.

Setting: Acute Inpatient Rehabilitation Hospital

Assessment/Results: The patient’s mobility improved from requiring maximal to moderate assistance with a two-wheeled walker, after two weeks of treatment for Candida Lusitanae. Two months after admission, the patient was admitted to the Neurological Intensive Care Unit after worsening CSF leak, generalized tonic-clonic seizures, and persistent Candida lusitaniae infection unresponsive to flucytosine. The addition of fluconazole led to clinical improvement, allowing his transition to acute inpatient rehabilitation.

Discussion (relevance): Candida lusitaniae is an emerging opportunistic pathogen in immunocompromised patients, but is an uncommon finding in immunocompetent hosts that is challenging to control. This is the first reported case, to our knowledge, of Candida lusitaniae fungal meningitis in an immunocompetent patient with a severe penetrating TBI.

Conclusions: Considering fungal meningitis infections in TBI patients with GSWs to the head is imperative for comprehensive multidisciplinary care, even in immunocompetent individuals. Early recognition and timely antifungal treatment of such conditions could prevent prolonged hospitalizations, delays in medical interventions, and hindered functional rehab progress.