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Meningitis - cryptococcal

Meningitis - cryptococcal


Cryptococcal meningitis

Cryptococcal meningitis is a fungal infection of the tissues covering the brain and spinal cord (meninges).

I Would Like to Learn About:

  • Causes

    Cryptococcal meningitis is caused by the fungus Cryptococcus neoformans. This fungus is found in soil around the world.

    Cryptococcal meningitis most often affects people with a weakened immune system. Risk factors include:

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

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

  • Symptoms

    Unlike bacterial meningitis, this form of meningitis comes on more slowly, over a few days to a few weeks. Symptoms may include:

    • Fever
    • Hallucinations
    • Headache
    • Mental status change
    • Nausea and vomiting
    • Sensitivity to light (photophobia)
    • Stiff neck
  • Exams and Tests

    A doctor or nurse will examine you. This will usually show:

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

    A lumbar puncture ("spinal tap") is an important test for diagnosis meningitis. This test is done to remove a sample of cerebrospinal fluid (CSF).

    Tests that may be done include:

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

    Antifungal 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, and may be used later in the course of treatment.

  • Outlook (Prognosis)

    People with AIDS who recover from cryptococcal meningitis need long-term treatment with medication to prevent the infection from coming back and to boost their immune system.

  • Possible Complications

    • Brain damage
    • Hearing loss
    • Hydrocephalus
    • Seizures

    Amphotericin B can have side effects, including chills and stiffness, and sometimes kidney damage.

  • When to Contact a Medical Professional

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

    Call the local emergency number (such as 911) or go to an emergency room if you suspect meningitis in a young child who has the following symptoms:

    • Feeding difficulties
    • High-pitched cry
    • Irritability
    • Persistent, unexplained fever

Related Information

  HIV/AIDSHodgkin lymphoma...DiabetesHydrocephalus     Hodgkin's disease...Diabetes - type 1...


Kauffman CA. Cryptococcosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 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):2016-25.


Review Date: 10/7/2012  

Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc. 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.

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