Fungal meningitis

Lore & Background

Fungal meningitis is caused by various fungi, including Candida, Coccidioides, Histoplasma, Blastomyces, Cryptococcus, and Aspergillus. Candida albicans is the most common Candida species causing central nervous system infections. Coccidioides is endemic to the southwestern United States and Mexico, and a third of patients with disseminated coccidioidomycosis develop meningitis. Histoplasma, found in bird and bat droppings, is endemic to parts of the United States, South, and Central America, with central nervous system involvement in 10-20% of disseminated cases.

Reader's Guide

Fungal meningitis is a serious infection of the membranes surrounding the brain and spinal cord, primarily affecting individuals with weakened immune systems. Its significance lies in its diagnostic challenges and the need for prolonged antifungal therapy. The prognosis varies widely depending on the causative fungus and patient risk group, with mortality rates ranging from 10-20% for Candida meningitis to poor outcomes for Aspergillus and coccidioidal infections. Outbreaks have occurred, such as the 2012 U.S. outbreak linked to contaminated injections, where Exserohilum rostratum was found in many cases. The condition underscores the importance of identifying the specific pathogen for appropriate treatment and highlights risks for immunocompromised populations.

Did You Know?

• Fungal meningitis symptoms include fever, stiff neck, severe headache, photophobia, nausea, vomiting, and altered mental status.
• Cryptococcus neoformans is the most common pathogen to cause fungal meningitis.
• As of November 5, 2012, the CDC reported 409 laboratory-confirmed cases and 30 fatalities from fungal meningitis caused by contaminated injections.
• In early 2023, cases of fungal meningitis were attributed to patients who received cosmetic surgery in Matamoros, Mexico.