Fungal Meningitis Symptoms: Risk Factors, Treatment & Prevention

Inflammation of meninges results in a medical condition known as meningitis. Meninges is a thin membrane sheath which covers the brain and spinal cord. Meningitis can occur from bacteria, viruses, fungus and various other microorganisms. Fungal meningitis is rare, but when it occurs, the condition is life threatening.

Fungi are simple plants lacking chlorophyll that depend on other living or dead organisms and thus termed parasitic or saprophytic. Fungi are pathogenic or opportunistic. The former mainly affect the normal host and the later usually affect the immune compromised individuals. The high risk group includes people suffering from HIV, cancer, and patients taking immunosuppressive drugs.

Infection occurs following inhalation of windblown spores from the soil. Fungi spreads to central nervous system via bloodstream once it enters in the susceptible individual.

What Are The Causes Of Fungal Meningitis?

As mentioned earlier, the most common cause of fungal infection is suppressed immunity or weak immune system. People suffering from HIV, cancer, diabetes having low immunity, and patients taking chemotherapy or radiotherapy, where the immune system is suppressed are susceptible to suffer from fungal meningitis.

There are varieties of fungi responsible for this neurological disorder. Among them the most common are Cryptococcus neoformans, candida.

The other fungi such as histoplasma, blastomyces are rarely responsible for meningitis. The organisms enter the body by inhaling airborne spores. It travels to brain and spine via blood.

A normal healthy individual may often inhale these fungi from environment, but they rarely suffer from meningitis because their immune system is healthy and strong. Fungi survive and cause infection only when the immune system is depressed.

Risk Factors For Fungal Meningitis

  • Patients taking immune suppressive drugs as in cancer, or organ transplant, steroids for long term are at greater risk of suffering from fungal meningitis.
  • Premature babies having low birth weight are at risk of contracting candida infection which may spread to the brain.
  • Living in certain environment which can cause fungal lung infection and ultimately spreading to brain resulting in meningitis. Birds and bats droppings often contain fungus that can cause meningitis. Cryptococcus is one such fungus infection which can be acquired through inhaling soil contaminated with dropping of bird. Blastomyces is a fungus which predominantly exists in soil containing decaying matter.
  • African Americans, pregnant women in third trimester, and people having weak immune system are at greater risk of suffering from fungal meningitis.

Fungal meningitis is not contagious. It is not transmitted from one person to another.

Symptoms Of Fungal Meningitis

The symptoms of fungal meningitis resemble those of any other type of meningitis. However, the symptoms are gradual in onset as compared to bacterial or viral meningitis. Fungus is only detected after examining CSF in a laboratory. Here are some of the clinical features of fungal meningitis.

  • High grade fever
  • Severe headache
  • Projectile Vomiting
  • Stiff neck
  • Cramps in legs and calf muscles
  • Drowsiness
  • Sensitivity to light
  • Confused state

In severe cases, there may be loss of memory, co-ordination problem, change in behavior and convulsion.

Treatment And Prevention Of Fungal Meningitis

Anti fungal medicines form the cornerstone of the treatment. Fungal meningitis requires to be treated with high doses and long course of anti fungal remedies. Patient suffering from fungal meningitis requires hospitalization. The time period for treating may depend on severity, and the immune status of the patient.

Patients suffering from cancer, HIV, organ transplant whose immunity is not strong may require long period of treatment. The average treatment may last at least for 6 weeks or until evidence of active symptoms of meningitis have disappeared. In immune compromised state, prolonged maintenance anti fungal therapy may be necessary. For cryptococci, the treatment is continued until four consecutive weekly cultures are sterile.

There is no specific activity which is suspected to cause fungal meningitis. The only way to prevent fungal meningitis, especially among people who are at risk is to avoid soil and environment which contain fungus. HIV and cancer patients should avoid visiting places of birds and bats droppings. Wearing a mask is essential for people who have recently undergone organ transplantation.