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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.
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]
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]
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)
Most of these conditions are opportunistic infections that are easily treated in healthy people. The staging system is different for adults and adolescents and children. [2] Stage I: HIV disease is asymptomatic and not categorized as AIDS. Stage II: include minor mucocutaneous manifestations and recurrent upper respiratory tract infections.
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.
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]
People who have C. gattii infection need to take prescription antifungal medication for at least 6 months; usually the type of treatment depends on the severity of the infection and the parts of the body that are affected. For people who have asymptomatic infections or mild-to-moderate pulmonary infections, the treatment is usually fluconazole.
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