DefinitionCryptococcal meningitis is a fungal infection of the membranes covering the brain and spinal cord (meninges).
See also:
Aseptic meningitis
Meningitis – gram-negative
Meningitis -nullH. influenzae
Meningitis – meningococcal
Meningitis – pneumococcal
Meningitis – staphylococcal
Meningitis – tuberculous
Alternative NamesCryptococcal meningitis
Causes, incidence, and risk factorsCryptococcal meningitis is caused by the fungus Cryptococcus neoformans. This fungus is found in soil around the world.
Cryptococcal meningitis most often affects people with compromised immune systems. Risk factors include:
AIDS
Diabetes
Lymphoma
It occurs in 5 out of 1 million people.
Symptoms
Fever
Hallucinations
Headache
Mental status change
Nausea and vomiting
Sensitivity to light (photophobia)
Stiff neck
Signs and testsIn order to diagnose cryptococcal meningitis, a lumbar puncture (spinal tap) must be performed. This test involves taking a sample of fluid from the spinal column (called cerebrospinal fluid or CSF). The following tests on the CSF allow the health care provider to diagnose cryptococcal meningitis:
CSF culture
CSF stains
CSF test for cryptococcus antigen
Serum cryptococcal antigen blood test
If you are diagnosed with cryptococcal jasa vasksin meningitis, your doctor will also recommend:
CT scan
MRI of the head
TreatmentAntifungal medications are used to treat this form of meningitis. Intravenous therapy with amphotericin B is the most common treatment. It is often combined with an oral medication, 5-flucytosine. An oral medication, fluconazole, in high doses may also be effective against this infection.
Expectations (prognosis)People with AIDS need long-term treatment with medication, to prevent the infection from coming back.
ComplicationsObstructive hydrocephalus is a complication. This occurs when the infection disrupts the normal movement of CSF around the brain and spinal cord. A tube called a shunt, which moves CSF around the obstruction, can relieve the pressure.
Amphotericin B can have side effects, including chills and stiffness, and sometimes kidney damage.
Calling your health care providerCall the local emergency number (such as 911) or go to the emergency room if you have symptoms of meningitis, or if you are being treated for meningitis and your symptoms get worse.
Go to the emergency room as quickly as possible if you have:
Changes in your senses or mental state
Difficulty breathing or swallowing
Numbness
Paralysis
ReferencesKauffman CA. Cryptococcosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 357.
