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FUNGAL MENINGITIS

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FUNGAL MENINGITIS

Fungal meningitis refers to meningitis caused by a fungal infection.

  • Meningitis is an inflammation of the membranes (meninges) surrounding the brain and spinal cord
  • Most cases of meningitis are caused by a viral infection, but bacterial, parasitic and fungal infections are other causes
  • Fungal infections can spread through the blood to the spinal cord and brain, resulting in meningitis
  • Fungal meningitis is rare, can be very fatal and is not contagious (cannot be transmitted from person to persons
  • Fungal meningitis can cause outbreaks, such as the highly-publicized one that occurred in 2012. During this outbreak, 438 people in 19 states across America were affected, killing 32 people as of November 2012. The outbreak was caused by injections with contaminated medication produced by a compounding pharmacy.

CAUSES

Fungal meningitis can develop after a fungus spreads through the bloodstream from somewhere else in the body. This may result from the direct introduction of the fungus into the central nervous system, or from having an infection in parts of the body closer to the central nervous system. The central nervous system is made up of the spinal cord and the brain.

Fungal meningitis can also develop after taking medications that weaken the immune system.

The following fungi are the most common causes of fungal meningitis and they are all transmitted in different ways. They include:

Cryptococcus is thought to be acquired through inhaling soil contaminated with bird droppings.

Histoplasma is found in environments with heavy contamination of birds and bats droppings and is predominantly found in the central and eastern region of the US, such as Ohio and Mississippi River valleys.

Blastomyces is thought to exist in soil rich decaying organic matter in the Midwest United States.

Candida usually occurs in hospital settings.

Coccidioides is found in the soil of endemic area, southwestern United States and Mexico. It is carried by wind and dust

Aspergillus which accounts for 5% of Central Nervous System fungi infection.

The following groups are at most risk for fungal meningitis, they include:

  • Individuals with a weakened immune system, including cancer patients, HIV patients, the elderly, individuals taking immunosuppressive medication, and premature babies with very low birth weight
  • Individuals living in high-risk areas, such as the Midwestern United States, and the Southwestern United States

SYMPTOMS

  • Fever
  • Headache
  • Stiff neck
  • Nausea and vomiting
  • Sensitivity to light
  • Confusion

DIAGNOSIS AND TREATMENT

If fungal meningitis is suspected, the doctor may make a diagnosis by testing samples of blood or cerebrospinal fluid (near the spinal cord) in the laboratory for pathogens.

Identifying the specific pathogen is very important because it will help to determine the proper cause of treatment.

TREATMENT

Fungal meningitis is treated with long courses of high dose antifungal medications usually given intravenously in the hospital. The duration of the treatment depends on the causal pathogen.

For patients with a weaker immune system because of other conditions such as HIV infection, cancer or diabetes, treatment will often take longer.