E-mail Form
Email Results

 
 
Print-Friendly
Bookmarks
bookmarks-menu

Meningitis - cryptococcal

Cryptococcal meningitis

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:

  • AIDS
  • Cirrhosis (a type of liver disease)
  • Diabetes
  • Leukemia
  • Lymphoma
  • Sarcoidosis
  • An organ transplant

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:

  • Blood culture
  • Chest x-ray
  • Cryptococcal antigen in CSF or blood, to look for antibodies
  • CSF examination for cell count, glucose, and protein
  • CT scan of the head
  • Gram stain, other special stains, and culture of CSF

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:

  • Nausea and vomiting
  • Fever and chills
  • Joint and muscles aches
  • 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

Centers for Disease Control and Prevention website. Fungal meningitis. www.cdc.gov/meningitis/fungal.html. Updated April 15, 2016. Accessed December 14, 2018.

Kauffman CA. Cryptococcosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 336.

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, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 264.

  • Central nervous system and peripheral nervous system

    Central nervous system and peripheral nervous system - illustration

    The central nervous system is comprised of the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.

    Central nervous system and peripheral nervous system

    illustration

    • Central nervous system and peripheral nervous system

      Central nervous system and peripheral nervous system - illustration

      The central nervous system is comprised of the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.

      Central nervous system and peripheral nervous system

      illustration


     

    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.

    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. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
    adam.com

     
     
     

     

     

    A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.
    Content is best viewed in IE9 or above, Firefox and Google Chrome browser.