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 travel or international meeting sponsorship from Biogen, Genzyme, Merck, Novartis and Teva; he may receive travel and/or meeting sponsorship from Bial and Genzyme in 2018-2019. AC has attended or may attend the Advisory Board meetings for product development and/or marketing with Bial, Merck, Novartis, and Teva. AC declares that these posts and payments do not constitute any competing interest in relation to the topic of fungal meningitis.
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.
Associate Professor of Medicine
University of Southern California
Keck School of Medicine
RAL declares that he has no competing interests.
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