Fungal cerebritis from intravenous drug abuse.

Three intravenous drug abusers (predominantly cocaine) developed a fulminant fungal cerebritis without any other identifiable predisposing factor. Two died and one survived with a severe neurologic deficit. Zygomycetes (nonseptated fungi) were identified in the brain tissue of two victims and Acremonium alabamensis was cultured from the brain tissue of the third. Fulminant fungal cerebritis in intravenous drug abusers (in the absence of any predisposing illness) may represent a unique variant of the acquired immunodeficiency syndrome (AIDS). Future surviving patients should be evaluated for the possibility of a cellular immune deficiency state in order to confirm this impression.