AUTHOR=Cui Yue , Meng Jiali , Zhang Jing , Wang Lin , Yan Haihan , Xia Han , Cao Jingrong , Wu Liyong 

TITLE=Case Report: A Case of Sarocladium strictum Meningoencephalitis in an Immunocompetent Patient After Invasive Operation

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.762763

DOI=10.3389/fmed.2021.762763

ISSN=2296-858X

ABSTRACT=<p>As an opportunistic phytopathogen, <italic>Sarocladium strictum</italic> has only been shown to cause neurological disease in immunocompromised patients, where antifungal therapy was not effective. We report a case of <italic>Sarocladium strictum</italic> meningoencephalitis in an apparently immunocompetent young woman who presented with severe headache and slight fever after undergoing transnasal endoscopic repair of cerebrospinal fluid rhinorrhea. Chronic sinusitis and suspicious intracranial fungal lesions were observed on enhanced magnetic resonance imaging (MRI). Both culture and metagenomic next-generation sequencing of her cerebrospinal fluid were positive for <italic>Sarocladium strictum</italic>. After local debridement, treatment with amphotericin B plus voriconazole and Ommaya reservoir implantation, the patient improved significantly. Unfortunately, her symptoms worsened again despite plenty of antifungal therapy for a month.</p>