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Cryptococcal meningitis accounts for about 68% of meningitis cases in those with HIV and has a mortality rate of 10-25%, with delays in diagnosis and treatment being especially common and associated with a poor prognosis. [5] The treatment for chronic infectious meningitis is directed at the underlying infectious agent.
Cryptococcal meningitis is a primary contributor to mortality among individuals with HIV/AIDS in sub-Saharan Africa. [63] Approximately 160,000 cases of cryptococcal meningitis are reported in West Africa, resulting in 130,000 deaths in sub-Saharan Africa. [64] Uganda is reported to have the highest occurrence of cryptococcus meningitis. [54]
Fungal meningitis, such as cryptococcal meningitis, is treated with long courses of high dose antifungals, such as amphotericin B and flucytosine. [55] [82] Raised intracranial pressure is common in fungal meningitis, and frequent (ideally daily) lumbar punctures to relieve the pressure are recommended, [55] or alternatively a lumbar drain. [53]
Meningitis is an unusual manifestation of blastomycosis and can be very difficult to diagnose. Cryptococcus (Cryptococcal meningitis) - it is thought to be acquired through inhalation of soil contaminated with bird droppings. C. neoformans is the most common pathogen to cause fungal meningitis.
A single high dose of liposomal amphotericin B with 14 days of flucytosine and fluconazole is recommended by the newest WHO guideline for cryptococcal meningitis. [36] A new study found that brain glucose can trigger amphotericin B (AmB) tolerance of C. neoformans during meningitis which means it needs longer treatment time to kill the fungal ...
Flucytosine may increase the toxicity of amphotericin B and vice versa, although the combination may be life-saving and should be used whenever indicated (e.g., cryptococcal meningitis). The cytostatic cytarabine inhibits the antimycotic activity of flucytosine. [citation needed]
Most forms of aseptic meningitis are viral in origin, though neoplastic and Lyme disease meningitis are also aseptic. California encephalitis virus; Central nervous system viral disease; Cytomegalovirus encephalitis; SARS-CoV-2; Eastern equine encephalitis; Enterovirus encephalitis; Epstein Barr Virus encephalitis; Herpes simplex encephalitis ...
IRIS may be the cause of paradoxically worse outcomes for cryptococcal meningitis in immunocompetent compared with immunocompromised hosts, in whom Cryptococcus neoformans is the usual pathogen. Treatment with systemic corticosteroids during IRIS may be beneficial in preventing death or progressive neurological deterioration.