Meningitis caused by Candida dubliniensis in a patient with meningioma: a systematic review of the literature

Abstract

Background Candida meningitis is a rare but life-threatening infection, most commonly caused by Candida albicans . Candida dubliniensis , despite its close phenotypic similarity to C. albicans , is an uncommon cause of central nervous system (CNS) infections, with limited data available. To date, only 12 cases of C. dubliniensis meningitis have been reported worldwide. This study presents the 13th documented case and the first reported from Türkiye, together with a systematic review of the literature. Case presentation A 44-year-old immunocompetent male developed meningitis caused by C. dubliniensis following subtotal resection of a clival meningioma. The diagnosis was established through fungal culture, MALDI-TOF MS, and ITS region DNA sequencing. The isolate was deposited in GenBank (accession number PV088619). Antifungal therapy with fluconazole was initiated based on susceptibility results. Despite appropriate antifungal management, the patient developed secondary Klebsiella pneumoniae sepsis and subsequently died, highlighting the complexity and high mortality risk associated with post-neurosurgical fungal CNS infections. Methods A systematic review was conducted according to PRISMA guidelines using PubMed and Web of Science databases, including studies published up to February 2025. Search terms included “ Candida dubliniensis ” and “meningitis.” Only microbiologically confirmed cases with individual patient data were included. Studies older than 25 years or lacking sufficient diagnostic detail were excluded. Results and conclusion Thirteen cases were identified. Most patients were immunocompetent, and infections were frequently acquired outside neurosurgical settings. Mortality was reported in four cases. These findings emphasize the extreme rarity of C. dubliniensis meningitis and underscore the importance of early species-level identification strategies.