What is Fungal Meningitis?

Meninges are membranous tissue layers covering the brain and the spinal cord. They provide protection and nutrition to these organs. The inflammation of these membranes due to fungal infection is called fungal meningitis. Meningitis can be of many other types classified on the basis of organism affecting the membranes.

Understanding Fungal Meningitis:

Fungal meningitis is rare and is mostly seen in immunocompromised (decreased immunity) patients like HIV patients. The fungus spreads to the brain following a skin or lung infection and causes inflammation of meninges and blood vessels of the brain. It can also affect the brain tissue in which case it will be known as fungal meningoencephalitis. The most common fungus causing meningitis is Cryptococcus.

What are the causes of Fungal Meningitis?

Normally we are exposed to many organisms in our environment that can potentially cause infections but our immune system prevents it. Fungi are present all around us, moist soil, bird droppings, decaying plants, etc. These fungi can enter the human body via inhalation of spores or by direct skin contact, reach the blood stream and cause disease. Some fungi like Candida naturally reside in the body without causing nuisance; but in people who are at risk can acquire infection and fungus can spread to the brain and spinal cord.

What are the risk factors for Fungal Meningitis?

  • Decreased immunity due to:
      • HIV
      • Patients on steroids
      • Medications taken after organ transplantation
      • Medications like TNF inhibitors taken for rheumatoid arthritis

What are the symptoms of Fungal Meningitis?

Following are the common symptoms seen in fungal meningitis:

  • Fever
  • Headache
  • Vomiting
  • Rigidity in the neck and back
  • Intolerance to light (Photophobia)
  • Altered consciousness
  • Seizures
  • It should be noted that fungal meningitis is not contagious i.e. it does not spread from person to person.

How is Fungal Meningitis diagnosed?

Physical examination:

  • Neck rigidity is assessed by flexing the neck
  • Other physical signs like Kernig’s sign and Brudzinski’s neck sign are checked

Laboratory investigations:

  • Cerebrospinal fluid (CSF) examination
  • Isolation and culture of fungi from CSF to identify the type of fungus involved
  • Blood counts
  • Intracranial pressure (ICP) is measured
  • Blood culture to look for organisms in the blood
  • Skin biopsy if any skin lesions are present
  • Chest X Ray to look for infection in the lung
  • CT scan may be required to have better view of pathology in the brain

What is the treatment for Fungal Meningitis?

Antifungal medicines are given either intravenously or orally depending upon the severity of the disease. The duration of treatment can vary from patient to patient depending on their immune status.

Also Read: Candidiasis: Overview, Symptoms and Treatment

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