What You Need to Know About Fungal Meningitis

Fungal meningitis is a rare fungal infection. It causes inflammation in the brain and spinal cord. It’s very serious and possibly life threatening, but getting early treatment can significantly improve its outcome.

Fungal meningitis is a rare fungal infection that causes swelling around the brain and spine.

It can be very serious and sometimes even life threatening. According to the Centers for Disease Control and Prevention (CDC) , even with treatment, the mortality rate of fungal meningitis is close to 50%.

Fungal meningitis can be difficult to diagnose but needs prompt treatment with antifungal medications. It’s not contagious and can’t spread from one person to another.

Learn more about meningitis.

What is fungal meningitis?

Fungal meningitis is when a fungal infection gets into the body and causes inflammation in the brain and spinal cord. In many cases, the fungus may spread to the brain or spinal cord from somewhere else in or on the body. It can be life threatening.

It’s most common in people with weakened immune systems, though anyone can contract fungal meningitis. Rarely, it’s possible to contract it in a healthcare or hospital setting.

The actual incidence rates of fungal meningitis are difficult to assess, as there’s no requirement to report it to public health boards.

What are the symptoms of fungal meningitis?

The symptoms of fungal meningitis tend to come on gradually, unlike symptoms of other forms of meningitis , which can appear more suddenly.

These symptoms can include:

• fever
• nausea
• vomiting
• light sensitivity
• a stiff neck
• headaches
• confusion or an altered mental state
• seizures

Serious complications are possible. They may include:

• stroke
• fluid in the brain
• bleeding in the brain ( hemorrhage )
• excess pressure in the brain
• obstruction of fluid flow around the brain and spinal cord, which can lead to fluid buildup and pressure around the brain ( hydrocephalus )
• seizures

If you’re experiencing any symptoms of fungal meningitis, contact a doctor right away. They can confirm your diagnosis and begin treatment.

What causes fungal meningitis?

Fungal meningitis can result from a variety of different fungi that live in the environment or in or on the body:

• Cryptococcus neoformans: This is the most common cause of fungal meningitis. This fungus is present in soil all over the world. It typically only affects people with weakened immune systems or underlying health conditions.
• Blastomyces: This fungus is present in decaying leaves, wood, and damp soil. It’s most common in the south-central, southeastern, and midwestern areas of the United States.
• Histoplasma: This fungus is usually harmless to healthy people and is present in soil with a high concentration of bird or bat droppings.
• Coccidioides: This fungus causes valley fever, which begins in the lungs and can travel to the central nervous system, developing into meningitis .
• Candida: This is the fungus that causes thrush in babies. It normally lives on the skin or in the gut without causing issues, but it can cause infection in people with weakened immune systems.

What are the risk factors for fungal meningitis?

Anyone can get fungal meningitis, but certain people are more vulnerable.

Risk factors for fungal meningitis include:

• a weakened immune system
• any health condition that weakens the immune system, such as HIV or cancer
• certain medications, such as steroids or anti-TNF drugs
• environmental exposure to fungi
• premature birth or low birth weight
• a recent surgical procedure, though this is rare

How do doctors diagnose fungal meningitis?

Fungal meningitis can be tough to diagnose . This is because it’s rare, because its initial symptoms can overlap with those of other conditions, and because the lab tests to confirm a diagnosis can be challenging.

The specific lab tests are susceptible to false-negative results and may take up to 2 weeks to turn positive. It’s also possible that several fungi or bacteria are present in an infection, which could complicate the lab tests.

The recommended tests for someone with suspected fungal meningitis include blood collection and a lumbar puncture test to collect cerebrospinal fluid (CSF), unless contraindicated. A specialist then tests these fluids for:

• bacterial and fungal cultures
• serum and CSF (1,3)-Beta-D-Glucan testing
• optional serum Aspergillus galactomannan and CSF fungal polymerase chain reaction testing

How do doctors treat fungal meningitis?

Treatment for fungal meningitis is most effective if it begins as soon as you suspect the condition. You must use strong, broad-spectrum antifungal medications.

You’ll typically receive these drugs through an IV line in a hospital setting, and you’ll likely be in the hospital for about 2 weeks .

After IV treatment, you may need oral medications for a period of time. The timing will depend on your immune system and the type of fungus that caused the infection. A standard time frame for taking oral antifungal medications is 3 to 6 months.

People with weakened immune systems may have an extended treatment.

What’s the outlook for people with fungal meningitis?

Fungal meningitis is a rare but serious condition that can be life threatening. The outlook for someone with fungal meningitis will depend on the type of fungus that caused the infection and their overall health.

In general, getting treatment as soon as you suspect fungal meningitis improves your outlook. But even with treatment, the mortality rate for fungal meningitis is close to 50% .

Frequently asked questions

How does a person get fungal meningitis?

You can get fungal meningitis by breathing in certain fungal spores from the environment. You can also get it from a fungal infection that spreads into the brain or spinal cord. It’s possible to get it in a healthcare setting from contaminated equipment, though this is rare.

Usually, only people with weakened immune systems will be susceptible to fungal meningitis.

Can you get fungal meningitis from mold?

Yes, but it’s very rare. Mold is a natural part of the environment and is a type of fungus. Some of the fungi that cause fungal meningitis can be classified as molds.

In 2012, there was an outbreak of meningitis due to a specific mold called exserohilum rostratum, or black mold . This outbreak resulted from a manufacturing error in a specific injected medication.

What is the survival rate of fungal meningitis?

The overall outlook for fungal meningitis depends on the specific fungus causing the infection and your overall health.

The CDC reports that mortality rates for fungal meningitis, even with treatment, are close to 50%. However, a recent study found a 21% mortality rate for people with acute fungal meningitis.

Takeaway

Fungal meningitis is a rare but serious fungal infection. It can lead to inflammation in the brain or spinal cord, and it can be fatal. It’s due to specific fungi present in the environment or on or in your body.

Most healthy people are unaffected by these fungi, but those with weakened immune systems are more vulnerable. If you suspect fungal meningitis, seek care immediately. Early treatment with antifungal medications can improve your chance of a full recovery.