Fungal Meningitis - is it Candida related??????????????

Fungal Meningitis

Meningitis is the inflammation of the meninges (the membrane lining of the brain and spinal cord). It usually refers to infections caused by viruses, bacteria, fungi or other microorganisms.

Fungal meningitis is a very rare, life threatening disease and may be caused by a variety of fungi, including most commonly Cryptococcus neoformans and Candida albicans .  Fungal meningitis usually occurs in people whose immune system has been severely depressed by disease (e.g. leukaemia or AIDS or by immunosuppressant drug therapy).

Cryptococcus neoformans is the most common cause of fungal meningitis. The organism is found in soil, is common in the environment and can be spread through the air.  The organism usually gains entry into the body when people inhale air-borne spores.  The vast majority of  healthy people will not develop an infection from these inhaled fungi, however people with severely depressed immune systems may be unable to prevent the fungi from surviving and causing infection.1

Cryptococcus neoformans can cause localised skin lesions, pulmonary disease (infection in the lung and airways) and disease of the central nervous system.  In some people the organism can spread to the meninges and cause meningitis.2

Fungal meningitis may develop slowly and the disease may be difficult to diagnose and treat.  However sometimes the onset of the infection can be acute and symptoms may develop quickly.

The symptoms of fungal meningitis are similar to other forms of meningitis and hospital tests are required to tell which organism is responsible for causing the disease.  The symptoms may include:

• Headache
• Neck Stiffness
• Nausea and vomiting
• Muscle or joint pain
• Drowsiness / Confusion
• Dislike of bright lights
• Convulsions
• Altered mental state
• Feber
• Dizziness
• Problems with coordination
• Memory Loss
• Behavioural changes (such as irritability)
• Problems with vision

The symptoms do not need to occur in any order and may not all be present. If you think you may have meningitis seek medical attention and advice quickly.

Diagnosis is usually based on the analysis of blood and cerebrospinal fluid (CSF) samples. Repeated lumbar punctures may be required to culture the organism.

Treatment typically involves the administration of antifungal medication, often two drugs in combination intravenously for some weeks initially . The overall duration of antifungal treatment (both intravenous and oral) will depend on a number of factors including whether a person has problems with their immune system and the type of fungus causing the infection.  The treatment often  take several weeks to months in people who do not have problems with their immune system.  However people with lowered immunity may require prolonged therapy and many also require long-term maintenance on antifungal therapy.5

Unlike some other meningitis infections (eg meningococcal), there is no risk of someone with fungal meningitis spreading the infection to other people.  There is no vaccine for fungal meningitis.

Disclaimer

The Meningitis Centre is a 'not for profit' support organisation based in Australia, not a professional medical authority. Consequently text contained on this website   provides general information about meningitis and septicaemia, not medical advice and is not intended for use in the diagnosis or treatment of the disease. Please consult your doctor to discuss the information or if you are concerned someone may be ill. Medical information and knowledge changes quickly and you should contact your doctor for further information or if you are concerned about your health.

 

References

1. Meningitis  Research Foundation. (2003). About the diseases - Fungal Last accessed, Meningitis Research Foundation. 20/3/03. www.meningitis.org/sect5/subsect10  
2. Cryptococcosis, Mycology Online. Cryptococcosis, Uinversity of Adelaide Australia. 18/3//2003,.,. www.mycology.adelaide.edu.au/mycology/myco.nsf/2006532373646b77692565 New site http://www.mycology.adelaide.edu.au/Mycoses/Opportunistic/Cryptococcosis/index.html    
3. Cryptococcosis, Mycology Online. Cryptococcosis, Uinversity of Adelaide Australia. 18/3//2003,. www.mycology.adelaide.edu.au/mycology/myco.nsf/2006532373646b77692565 New site http://www.mycology.adelaide.edu.au/Mycoses/Opportunistic/Cryptococcosis/index.html   
4. Meningitis  Research Foundation. (2003). About the diseases - Fungal Last accessed, Meningitis Research Foundation. 20/3/03. www.meningitis.org/sect5/subsect10   5. Saag. M. et. al. (2000). " Practice Guidelines for the Management of Cryptococcal Disease." Clinical Infectious Diseases 30: 710 - 718.  
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