Meningitis - cryptococcal

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

  • Alternative Names
    • Cryptococcal meningitis

  • Causes
    • Most cryptococcal meningitis is caused by the fungus Cryptococcus neoformans. This fungus is found in soil around the world. Another type of Cryptococcus can also cause meningitis, but it will not be disscussed here.

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

      It 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. You will likely have a:

      • Fast heart rate
      • Fever
      • Mental status change
      • Stiff neck

      A lumbar puncture (spinal tap) is an important test for diagnosing 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 medication, fluconazole, in high doses may also be effective against this infection, and may be prescribed later.

  • Outlook (Prognosis)
    • People who recover from cryptococcal meningitis need long-term treatment with medication to prevent the infection from coming back. People with weakened immune systems, such as people with 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, including chills and stiffness, and sometimes kidney damage.

  • 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:

      • Feeding difficulties
      • High-pitched cry
      • Irritability
      • Persistent, unexplained fever
  • References
    • Kauffman CA. Cryptococcosis. In: Goldman L, Ausiello D, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 344.

      Thigpen MC, Whitney CG, Messonnier NE, et al. Emerging Infections Programs Network. Bacterial meningitis in the United States, 1998-2007. N Engl J Med. 2011 May 26;364(21):2016-2025.