Typically presents as a progressive, life-threatening, chronic or subacute meningitis.
Occurs most commonly in immunosuppressed individuals and is often accompanied by systemic involvement.
Cerebrospinal fluid (CSF) typically shows lymphocytic pleocytosis, elevated protein, and low glucose.
The most common type of fungal meningitis is caused by Cryptococcus neoformans .
A rapid etiologic diagnosis is required to guide antifungal therapy.
Complications include seizures, cerebral infarction, hydrocephalus, and elevated CSF pressure without hydrocephalus.
Meningitis is an inflammatory disease of the leptomeninges. All major fungal pathogens have the capacity to cause meningitis. The incidence of fungal meningitis is increasing worldwide due to the increasing number of patients immunosuppressed by pharmacologic agents and HIV infection. Cryptococcal, histoplasmal, coccidioidal, and candidal meningitis will be discussed specifically in this monograph.      
Clinical Lead of Neuroinflammation
Department of Neurology
AC has received honoraria, speaker fees, and sponsorship for attending meetings from the following pharmaceutical companies during the past 3 years: Novartis, Biogen Idec, Eisai, Terumo BCT, Genzyme. Financial compensations received from his pharmaceutical consultancy have been publicly declared in the UK disclosure website of the Association of the British Pharmaceutical Industry (ABPI). AC declares that these interests do not influence or compromise his role as a contributor.
Dr Abhijit Chaudhuri would like to gratefully acknowledge Dr Thomas S. Harrison and Dr Angela Loyse, previous contributors to this monograph. TSH and AL declare that they have no competing interests.
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