Learn About Cryptococcal Meningitis

What is the definition of Cryptococcal Meningitis?

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

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What are the alternative names for Cryptococcal Meningitis?

Cryptococcal meningitis

What are the causes of Cryptococcal Meningitis?

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 patients 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 infection.

Cryptococcus neoformans 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.

What are the symptoms of Cryptococcal Meningitis?

This form of meningitis starts slowly, over a few days to a few weeks. Symptoms may include:

  • Fever
  • Hallucinations
  • Headache
  • Mental status change (confusion)
  • Nausea and vomiting
  • Sensitivity to light
  • Stiff neck
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What are the current treatments for Cryptococcal Meningitis?

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.

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What is the outlook (prognosis) for Cryptococcal Meningitis?

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.

What are the possible complications of Cryptococcal Meningitis?

These complications may occur from this infection:

  • Brain damage
  • Hearing or vision loss
  • Hydrocephalus (excessive CSF in the brain)
  • Seizures
  • Death

Amphotericin B can have side effects such as:

  • Nausea and vomiting
  • Fever and chills
  • Joint and muscles aches
  • Kidney damage
When should I contact a medical professional for Cryptococcal Meningitis?

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
Central nervous system and peripheral nervous system
What are the latest Cryptococcal Meningitis Clinical Trials?
Encochleated Oral Amphotericin for Cryptococcal Meningitis Trial
Summary: This study is designed as two sequential trials. The first is a phase I open label trial to evaluate the safety and tolerability of MAT2203. The maximal tolerated and non-toxic daily dose,will then be moved forward into a multi-day safety trial. The Phase II trial will investigate toxicity and early fungicidal activity (EFA) of MAT2203 with flucytosine.
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Evaluation of CrAg Screening With Enhanced Antifungal Therapy for Asymptomatic CrAg+ Persons
Summary: This will be a randomized controlled trial of asymptomatic (Cryptococcal Antigen test)CrAg positive persons in Uganda.~Patients will be randomized to receive preemptive treatment with 1 dose of liposomal amphotericin (10mg/kg) in addition to standard of care fluconazole therapy.~How the enhanced antifungal therapy prevents progression to meningitis in the first 24-weeks and overall survival in tho...
What are the Latest Advances for Cryptococcal Meningitis?
Lenalidomide potentially reduced the level of cell- associated HIV RNA and improved persistent inflammation in patients with HIV-associated cryptococcal meningitis a pilot study.
Summary: Lenalidomide potentially reduced the level of cell- associated HIV RNA and improved persistent inflammation in patients with HIV-associated cryptococcal meningitis a pilot study.
Comparison of amphotericin B deoxycholate in combination with either flucytosine or fluconazole, and voriconazole plus flucytosine for the treatment of HIV-associated cryptococcal meningitis: a prospective multicenter study in China.
Summary: Comparison of amphotericin B deoxycholate in combination with either flucytosine or fluconazole, and voriconazole plus flucytosine for the treatment of HIV-associated cryptococcal meningitis: a prospective multicenter study in China.
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Outcomes of flucytosine-containing combination treatment for cryptococcal meningitis in a South African national access programme: a cross-sectional observational study.
Summary: Outcomes of flucytosine-containing combination treatment for cryptococcal meningitis in a South African national access programme: a cross-sectional observational study.
Who are the sources who wrote this article ?

Published Date: December 24, 2020
Published 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.

What are the references for this article ?

Centers for Disease Control and Prevention website. Fungal meningitis. www.cdc.gov/meningitis/fungal.html. Updated August 06, 2019. Accessed February 18, 2021.

Kauffman CA, Chen S. Cryptococcosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 317.

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.