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November 6, 1981

Focal Intracranial Mucormycosis Presenting as Chronic Meningitis

Author Affiliations

From the Departments of Medicine (Drs Jones, Gilman, and Medeiros) and Pathology (Drs Dyckman and Medeiros), Miriam Hospital and Brown University Medical School, Providence, RI.

JAMA. 1981;246(18):2063-2064. doi:10.1001/jama.1981.03320180055033

INTRACRANIAL mucormycosis occurs almost exclusively in patients with predisposing diseases. The infection is usually a result of either direct intracranial invasion or hematogenous spread. Isolated intracranial infection is rarely seen. We describe an unusual case of focal intracranial mucormycosis, presenting as chronic meningitis of several months' duration. A parameningeal focus, osteomyelitis of the clivus, was ultimately discovered, and the patient was successfully treated with neurosurgery and amphotericin B.

Report of a Case  A 61-year-old maintenance man was seen in an emergency room for headache on March 8, 1979, and was found to have mild hyperglycemia. One week later, diplopia developed and he was consequently admitted to the Miriam Hospital, Providence, RI.Physical examination revealed an alert, well-oriented man complaining of severe headache. Neurological examination demonstrated a right lateral rectus paralysis but otherwise gave normal results. The neck was supple. Serum glucose concentration was 286 mg/dL. There was no ketoacidosis. The