Cryptococcal meningitis is a life-threatening infection that can occur if there has been exposure to a fungus
called Cryptococcus neoformans. This fungus is found in the environment worldwide, particularly in soil contaminated with bird droppings. This fungus enters the body most commonly through the lungs.
Infection does not usually appear until a person's CD4 counts have dropped below 100. Cryptococcal meningitis can not be passed from one person to another. This fungus most commonly affects the brain,
causing the condition called meningitis. Meningitis is an infection and swelling of the lining of the brain and spinal cord. Cryptococcus can also cause infections of the lungs, skin and prostate gland.
Symptoms: What do I look for?
Cryptococcal meningitis may be very slow in developing, so at first, very vague symptoms may appear: mild headache, fever, nausea.
- As the infection progresses, more symptoms will appear if it is not treated:
- severe headache, nausea with vomiting, blurred vision and/or sensitivity to bright light, stiff neck, seizures, confusion, behaviour changes, coma.
- Meningitis can be mistaken for other types of brain infections.
Special tests are needed to confirm Cyptococcal meningitis:
Lumbar puncture (spinal tap):
taking fluid from your spinal column through a needle in your back. This fluid in then sent for special tests. Blood tests: to check whether you have been exposed to the fungus.
Can Cryptococcal meningitis be prevented?
Although it is impossible to avoid exposure to this common fungus, people with advanced HIV disease should wear gloves when gardening and generally be careful
around bird roosts. At present, there are no proven treatments to prevent this infection, however, studies are in progress. Early detection of the disease and reporting your symptoms is important so that
proper treatment can be started.
How is Cryptococcal meningitis treated?
When a person is diagnosed with cryptococcal meningitis, treatment with antifungals begins immediately. These medications
are usually given intravenously (directly into the vein). Amphotericin B and fluconazole (Diflucan) are the most common drugs used to treat the infection. Once the infection has been treated, it is
recommended that the person remain on one of the these drugs for the rest of their lives to prevent the infection from returning again.
References
Philips, Peter, (1994)
. "Fungal Infections in AIDS Patients", Grand Rounds in Infectious Diseases, 4, (10), 5-11.
Sande, Merle & Volberding, Paul, (1992). The Medical Management of AIDS, 3rd ed. Philadelphia: W.B.
Saunders Co. White, Mary &
Armstrong, Donald, (1994). "Cryptococcosis" in Infectious Disease Clinics of North America, 8, (2), 383-398.
