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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]
Conditions where a presumptive diagnosis can be made on the basis of clinical signs or simple investigations: Moderate unexplained malnutrition not adequately responding to standard therapy; Unexplained persistent diarrhoea (14 days or more) Unexplained persistent fever (intermittent or constant, for longer than one month)
Management generally involves symptom control and treatment of the underlying infection. In severe cases of IRIS, corticosteroids are commonly used. Important exceptions to using corticosteroids include Cryptococcal meningitis and Kaposi’s sarcoma, as they have been associated with poorer outcomes. [3] [4]
The treatment of non-systemic Candida infections of the vagina ("yeast infections"), throat, and mouth. Certain systemic Candida infections in people with healthy immune systems, including infections of the bloodstream, kidney, or joints. Other antifungals are usually preferred when the infection is in the heart or central nervous system, and ...
Infection begins in the lungs, and from there the fungus can disseminate to the brain and other body parts via macrophages. An infection of the brain caused by C. neoformans is referred to as cryptococcal meningitis, which is most often fatal when left untreated. [5] [29] Cryptococcal meningitis causes more than 180,000 deaths annually. [30]
It is considered first line therapy for invasive mucormycosis infections, cryptococcal meningitis, and certain aspergillus and candidal infections. [11] [12] It has been a highly effective drug for over fifty years in large part because it has a low incidence of drug resistance in the pathogens it treats. This is because amphotericin B ...
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