Cryptococcal meningitis is a severe infection of the membranes of the brain and the spinal cord. It can be an extremely debilitating and painful condition and can cause damage to the brain.
The following paragraphs describe the common causes, symptoms, diagnosis techniques and treatment options of the disease.
What are the causes, incidence and risk factors?
Cryptococcal meningitis is caused by a fungus called Cryptococcus neoformans. The fungus is very commonly found in the environment in soil and bird excreta. If soil having Cryptococcus neoformans is puffed up into the air, it can get inhaled and deposited on the lungs. From there, the fungus can get into the bloodstream and travel to the brain and spinal cord where it can cause infection. Cryptococcal meningitis occurs in 5 out of a population of 1 million. Common risk factors of the disease include diabetes, AIDS and lymphoma (a kind of cancer).
What are the signs and symptoms?
The first symptoms of cryptococcal meningitis include fever, nausea, stiff neck, fatigue, photophobia, vomiting and headache. The disease may also cause you to become confused or have memory loss. Family members or friends may notice small changes in the personality or behavior. If people with cryptococcal meningitis are not treated, they may lapse into coma or even die.
How is it diagnosed?
Two methods are frequently used to make a diagnosis of cryptococcal meningitis. The first method involves conducting a blood test, the serum cryptococcal antigen test, to detect Cryptococcus infection in the bloodstream. The second method involves a fluid known as cerebrospinal fluid (CSF) that is located around the brain and the spinal cord. To collect this fluid, a doctor or a technician performs a procedure called lumbar puncture, also known as spinal tap. After removing a small amount of CSF from the spine, the sample is examined for Cryptococcus neoformans in a laboratory.
How is it treated?
Cryptococcal meningitis can be divided into two types of treatment- mild and severe.
For the treatment of mild cryptococcal meningitis, fluconazole (Diflucan) is normally prescribed. Fluconazole is available in a pill form and high doses of the medicine (400 mg to 800 mg) can be taken orally every day for about three months.
It is important to treat severe cryptococcal meningitis aggressively. In this case, the medicine amphotericin B (Fungizone) is given every day through an IV line for the first two weeks of treatment. Also, a second drug flucytosine (Ancobon) is given orally. After two weeks of taking amphotericin B and flucytosine, you need to have another blood test and/or spinal tap conducted for verifying Cryptococcus neoformans. If the test result is positive, treatment for mild Cryptococcal meningitis is started. Otherwise the same treatment is continued.
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