Cryptococcal meningitis DefinitionCryptococcal meningitis is a fungal infection of the tissues covering the brain and spinal cord. These tissues are called meninges. CausesIn 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, but this form can cause disease in patients with a normal immune system as well. 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. Cryptococcus neoformans 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. SymptomsThis form of meningitis starts slowly, over a few days to a few weeks. Symptoms may include:
Exams and TestsYour 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:
TreatmentAntifungal 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 ComplicationsThese complications may occur from this infection:
Amphotericin B can have side effects such as:
When to Contact a Medical ProfessionalCall 911 or the local emergency number 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:
ReferencesCenters for Disease Control and Prevention website. Meningitis. About fugal meningitis. www.cdc.gov/meningitis/about/fungal-meningitis.html. Updated January 5, 2024. Accessed June 18, 2024. Kauffman CA, Chen S. Cryptococcosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 317. Perfect JR. Cryptococcosis (Cryptococcus neoformans and Cryptococcus gattii). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 262. | |
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Review Date: 12/4/2022 Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. | |
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Central nervous sy...
