Fungal Meningitis

Fungal meningitis is a fungal infection that causes inflammation around your brain and spinal cord. It can happen if you have a weakened or suppressed immune system.

Meningitis can be fatal. Go to an emergency room if you have symptoms like confusion, severe headache or stiff neck.

Many types of fungus can cause fungal meningitis. Some you breathe in from the soil around you. Others naturally live on your skin and can sometimes grow out of control. Meningitis isn’t contagious.

Symptoms of fungal meningitis

Fungal meningitis symptoms can affect your thinking, vision and how you feel overall. They may come on slowly, over days or weeks. They include:

• Headache
• Stiff neck
• Nausea or vomiting
• Confusion or mental changes
• Double vision
• Drooping eyelid
• Sensitivity to light
• Seizures

Fungal meningitis causes

Fungal meningitis can happen when a fungal infection travels from one part of your body to your brain or spinal cord. Cryptococcus (C. neoformans and C. gattii) fungi are the most common cause of fungal meningitis in people who have a compromised immune system.

Other causes include:

• Blastomyces
• Candida
• Coccidioides
• Histoplasma

Most of these fungi live in the soil in different parts of the U.S. They can infect you when you breathe them in. Most people who get an infection this way have a weakened immune system.

Candida naturally lives on your body. Sometimes, you can get an infection inside your body that spreads to your brain and spinal cord. Rarely, you can get a fungal infection through surgery or while staying in the hospital.

Is fungal meningitis contagious?

No, fungal meningitis isn’t contagious. But some of the types of fungi that can lead to meningitis, like Candida, do spread from person to person. Just because you get a fungal infection doesn’t mean it will cause meningitis.

Risk factors

You’re at a higher risk for fungal meningitis if you have a weakened immune system. This includes preterm infants and people who:

• Have HIV
• Have cancer
• Take certain medications for an autoimmune disease

How doctors diagnose fungal meningitis

Healthcare providers diagnose fungal meningitis by testing your blood and spinal fluid (lumbar puncture). This helps determine the cause of the swelling and how to treat it. They’ll also usually get images of the inside of your head, like a CT scan or MRI.

How is fungal meningitis treated?

Providers treat fungal meningitis with antifungal medications, given directly into a vein (IV) in the hospital. They may also give you corticosteroids to reduce inflammation.

When should I see my healthcare provider?

If you have a weakened immune system, talk to your provider about how to prevent infections and what to do if you think you have one. Go to the ER if you have symptoms of fungal meningitis.

Can you recover from fungal meningitis?

Yes. You may need to take antifungal medications for weeks or months to fully get rid of the infection. You’ll need treatment in the hospital for at least some of that time. If you have HIV, your provider may need to adjust your antiretroviral treatments.

Sometimes, symptoms can come back after treatment, especially if you have a weakened immune system.

What’s the survival rate for fungal meningitis?

Survival rates vary depending on the type of fungal infection, where you live and whether you have a weakened immune system. For example, experts estimate an 80% survival rate for people with HIV and Cryptococcus meningitis in North America (including the U.S. and Canada), with treatment. But in parts of Africa, the survival rate is estimated to be around 30%.

The area of the world you live in greatly impacts the healthcare that’s available to you. This can impact survival rates.

Can this be prevented?

If you have a weakened immune system, you can take some steps to reduce your risk of fungal infections that can lead to fungal meningitis. These include:

• Avoiding areas that expose you to dirt or dust
• Closing your windows and staying inside during dust storms
• Running high-efficiency particulate air (HEPA) filters in your home
• Wearing an N95 respirator mask during activities like gardening, digging or other yard work that can expose you to fungal spores

If your provider recommends it, you might also:

• Get tested and treated for fungal infections before starting HIV treatment
• Take antifungal treatment to prevent an infection if you’re at high risk