• J Emerg Med · Mar 2017

    Case Reports

    A Rare Central Nervous System Fungal Infection Resulting from Brown Heroin Use.

    • Eric M Melnychuk and David P Sole.
    • Department of Emergency Medicine, Geisinger Medical Center, Danville, Pennsylvania.
    • J Emerg Med. 2017 Mar 1; 52 (3): 314-317.

    BackgroundFungal nervous system infection can be a difficult diagnosis to make, due to the fact that there are no specific manifestations of the disease and laboratory confirmation is difficult to confirm.Case ReportWe report a young male who presented to our emergency department with a variety of unilateral visual field complaints. While he initially denied recent IV drug abuse, his physical examination was highly suggestive of a fungal infection known to result from brown heroin use. He was ultimately diagnosed with meningitis, ventriculitis, and endogenous endophthalmitis believed to result from a Candida species. The response to treatment with vitrectomy and broad-spectrum antimicrobials gave support to the presumed diagnosis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: We provide a rarely described report of a possible complication from the use of IV brown heroin that led to a central nervous system infection involving vision loss by fungal infection.Copyright © 2016 Elsevier Inc. All rights reserved.

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