Fungal Meningitis in an Allegedly Immunocompetent Patient in Sri Lanka: A Case Report

Abstract

Fungi are a significant source of microorganisms, which cause disability and death. They act as opportunistic pathogens in the immunocompromised host. Though it is rare among immunocompetent patients, a 44-year-old allegedly immunocompetent woman developed a sudden onset of headache which was holocranial but radiated to the occipital and neck region gradually and ended up with altered agitated behavior and presented to the Emergency Treatment Unit of National Hospital of Sri Lanka. Cerebrospinal fluid analysis revealed the diagnosis of probable Cryptococcal meningitis. Despite free health care system for every citizen of the country with the current economic burden, the management of prevailing treatment became complicated. Administering IV Conventional amphotericin B instead of the ideal treatment of IV Lymphosomal Amphotericin B showed numerous side effects and toxicity systemically in general and specifically on the genitourinary tract of the patient. At the same time, it opened access to a debatable question on assessing the value of disease-centered care and holistic approaching methods especially for the health care professionals. Meanwhile, this study discusses the assessment and implementation of nursing care considering the complications of drug toxicity and adverse effects combined with psychologically negative behavior due to pronged hospitalization for more than 35 days. This case study reveals the impact of nurses’ knowledge and understanding in providing care for the management of rare diseases like fungal meningitis. To provide comprehensive care nurses and the health care team must work together with updated knowledge and hands-on skills for a better patient outcome.