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Meningitis - cryptococcal

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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, but this form can cause disease in people 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 initial infection.

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

Cryptococcus neoformans meningitis 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 the space around 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 medicine, fluconazole, may also be effective in high doses. 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 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 the 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
Review Date: 11/10/2024

Reviewed By

Jatin M. Vyas, MD, PhD, 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.

References

Centers for Disease Control and Prevention website. Meningitis. About fugal meningitis. www.cdc.gov/meningitis/about/fungal-meningitis.html. Updated January 7, 2025. Accessed March 13, 2025.

Chen SC-A. Cryptococcosis. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 309.

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.

Disclaimer

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 system and peripheral nervous system

The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.

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Central nervous system and peripheral nervous system - Illustration Thumbnail

Central nervous system and peripheral nervous system

The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes nerves outside the brain and spinal cord.

Illustration

 
 
 
 
 
 

 

 
 
 
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