Meningitis - cryptococcal

Definition

Cryptococcal meningitis is a fungal infection of the tissues covering the brain and spinal cord. These tissues are called meninges.

Causes

In most cases, cryptococcal meningitis is caused by the fungus Cryptococcus neoformans. This fungus is found in soil around the world. Cryptococcus gattii can also cause meningitis.

This type of meningitis is not spread from person to person. Usually, it spreads through the bloodstream to the brain from another place in the body that has the infection.

Cryptococcal meningitis most often affects people with a weakened immune system, including people with:

The disease is rare in people who have a normal immune system and no long-term health problems.

Symptoms

This form of meningitis starts slowly, over a few days to a few weeks. Symptoms may include:

Exams and Tests

Your health care provider will examine you and ask about your symptoms.

A lumbar puncture (spinal tap) is used to diagnose meningitis. In this test, a sample of cerebrospinal fluid (CSF) is removed from your spine and tested.

Other tests that may be done include:

Treatment

Antifungal medicines are used to treat this form of meningitis. Intravenous (IV, through a vein) therapy with amphotericin B is the most common treatment. It is often combined with an oral antifungal medicine called 5-flucytosine.

Another oral drug, fluconazole, in high doses may also be effective. If needed, it will be prescribed later in the disease course.

Outlook (Prognosis)

People who recover from cryptococcal meningitis need long-term medicine to prevent the infection from coming back. People with weakened immune systems, such as those with HIV/AIDS, will also need long-term treatment to improve their immune system.

Possible Complications

These complications may occur from this infection:

Amphotericin B can have side effects such as:

When to Contact a Medical Professional

Call your local emergency number (such as 911) if you develop any of the serious symptoms listed above. Meningitis can quickly become a life-threatening illness.

Call your local emergency number or go to an emergency room if you suspect meningitis in a young child who has these symptoms:


Review Date: 12/1/2018
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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