Understanding Cryptococcal Meningitis
Cryptococcal meningitis is a serious fungal infection often found in people with weakened immune systems, particularly those living with advanced HIV.
What is Cryptococcal Meningitis?
Cryptococcal meningitis is a fungal infection caused by *Cryptococcus neoformans*, often found in bird droppings. When inhaled, the spores can spread from the lungs to the brain and spinal cord, causing meningitis. This infection is rare in healthy people but is a leading cause of death in individuals with advanced HIV.
Impact of Cryptococcal Meningitis
Cryptococcal meningitis is responsible for 15% of all AIDS-related deaths worldwide, primarily in Africa. In 2014, 223,100 cases of cryptococcal meningitis resulted in 181,100 deaths of people living with HIV. Without treatment, cryptococcal meningitis is fatal.
Current Treatments for Cryptococcal Meningitis
The World Health Organization recommends a combination of amphotericin B and flucytosine for one week, followed by fluconazole for at least a year. However, in practice, fluconazole is often used alone, which is less effective. Amphotericin B, while effective, can be toxic to the kidneys and is difficult to administer in many settings.
New Treatments for Cryptococcal Meningitis
Effective treatments exist but are often inaccessible due to cost and availability. There is a need for less toxic drugs like liposomal amphotericin B and a sustained-release formulation of flucytosine that can be taken less frequently. Improved access to these treatments is critical to reducing deaths from cryptococcal meningitis.
How Do You Get Cryptococcal Meningitis?
People become infected with cryptococcal meningitis by breathing in fungal spores from the environment, often from bird droppings. It does not spread between people. Individuals with weakened immune systems, such as those with unsuppressed HIV infection or cancer, are at higher risk.
Symptoms of Cryptococcal Meningitis
Symptoms may develop within a few days or weeks and include fever, headache, stiff neck, nausea, vomiting, and sensitivity to light. If left untreated, more severe symptoms such as brain damage, coma, and hearing loss can occur. Without treatment, cryptococcal meningitis is fatal.
How is Cryptococcal Meningitis Diagnosed?
Cryptococcal meningitis is diagnosed by testing a sample of cerebrospinal fluid obtained via lumbar puncture. A rapid antigen test or an India ink test is used to confirm the infection. If a lumbar puncture is not possible, a blood sample may be tested.