You’ve probably heard of fungal meningitis, but are you aware of how it is caused, and what are its symptoms? Read on to find out everything you need to know about fungal meningitis.
What is meningitis?
In the word meningitis, ‘mening-’ comes from the word meninges, which are the three membranes encasing the central nervous system and the brain, and ‘-itis’ refers to inflammation. More specifically, it is the inflammation or swelling of the inner two layers, called the leptomeninges. Bacteria, viruses, or fungi can cause meningitis.
What is fungal meningitis?
Fungal meningitis is the rarest of the three types. It occurs when a fungal infection from elsewhere in the body infiltrates the spinal canal to reach the spinal cord and brain and causes swelling of the protective meninges.
This type of meningitis is rare because healthy individuals are highly unlikely to catch it. If you and your family have healthy and functioning immune systems, your body’s defense mechanism is sufficient to fight off the fungi. However, if you suffer from an autoimmune disease such as AIDS or cancer, the chances of fungal meningitis severely increase.
What causes fungal meningitis?
A fungal infection that isn’t fought off by the immune system in time can cause fungal meningitis. However, this disease is not contagious between two individuals. The infection may be contracted from the environment and spread to the central nervous system or a neglectful side effect of a medical procedure involving entering the spinal canal by piercing an infected site.
Many of the fungi causing fungal meningitis symptoms live in the environment and may also be present on the surface of your body. The prevalence of these is different throughout the world. Knowing which fungi are present in your part of the world is important in diagnosing the causative agent of fungal meningitis as a treatment for each may vary.
The most common cause of fungal meningitis is Cryptococcus since it is present in soil throughout the world. It is the most common cause of meningitis in adults in Africa. Moreover, it usually only causes meningitis in people with underlying health conditions such as HIV, cancer, and diabetes.
This fungus lives in soil with large amounts of bird or bat droppings and is a common cause of fungal meningitis. This is most common in central and eastern states of the US, mostly in areas around the Ohio and Mississippi rivers but rare elsewhere in the continent.
Blastomyces live in moist soil and decaying wood and leaves. It is found mostly in damp soils of wooded areas and water sources, such as the midwestern south-central and south-eastern states of the US.
This fungus lives in semiarid soil, which explains its distribution in Central and South America, some areas of Mexico, and southwestern parts of the US.
Naturally, candida lives on the surface and inside your body, such as on your skin, in your mouth, throat, gut, and vagina. Usually, it is a harmless fungus but can grow excessively and proliferate deeper in the body, such as in the bloodstream or to your internal organs, where it can then cause infection. It is usually acquired in a hospital setting.
What are the signs and symptoms of fungal meningitis?
Fungal meningitis presents symptoms similar to bacterial and viral meningitis; however, they may not appear as suddenly. Instead, they have a gradual onset. If you have fungal meningitis, you may experience:
- Stiff neck
- Nausea and vomiting
- Increased photosensitivity
In infants, fungal meningitis symptoms may present as:
- High fever
- Constant crying that gets louder when the baby is picked up
- A bulge in the soft part of the top of the baby’s head
- Sluggishness, inactivity
- Not being able to feed
If you sense a combination of these symptoms, consult a healthcare professional immediately as timely and effective treatment has proven to cure fungal meningitis.
Who is at risk?
Since the fungal infection needs to spread in the body without the body’s immune reaction inhibiting its growth, your chances of contracting fungal meningitis become higher when:
- You have an autoimmune disease or a weakened immune system
- You are taking immunosuppressive drugs (drugs that weaken the immune system).
Examples include those drugs administered after an organ transplant or in the treatment of autoimmune diseases.
Babies born prematurely with very low birth weights are also at high risk of candida spreading to the bloodstream, which may reach the brain.
How is it diagnosed?
If meningitis is suspected, the doctor will prescribe a cerebrospinal fluid (CSF) test. The only test that can diagnose meningitis is the CSF test. For this, the doctor will insert a needle into your spine to collect a sample of CSF from the spinal (vertebral) canal and send it to a laboratory for testing. Several lab tests will be performed to determine the cause of meningitis (viral, bacterial, or fungal) and the specific microorganism involved.
This is important since knowing the causative flora will help the doctor give a prognosis in the severity of the disease and determine the intensity of the treatment plan.
How is it treated?
Different types and dosages of anti-fungal medications are used to treat fungal meningitis. The amount of time taken to treat the disease depends on the type of fungus causing the inflammation. For patients with autoimmune diseases, treatment takes longer as compared to relatively healthy patients.
High-dose anti-fungal medications are administered intravenously at first, and later the patient must take medicine orally to complete the course. This medication is often administered over a long time; some may even require maintenance therapy, i.e., they must take their medication indefinitely.
According to a 2012-2013 study conducted in Virginia, the recovery rate of positively diagnosed patients who received treatment is 90.32%. It can be fatal if left untreated.
How can fungal meningitis be prevented?
Unlike viral meningitis, there are no vaccines to prevent fungal meningitis. Therefore, once contracted, rigorous treatment has to be undergone to cure the underlying cause of infection.
If you live in a place where Histoplasma, Coccidioides, and Cryptococcus exist and suffer from a weakened immune system, you should take special measures to prevent infection from these fungi.
- Fungi spread through spores that we can inhale, so avoid areas with dust and wear an N95 mask in such areas. This also means staying inside more during very windy or dusty conditions.
- You may want to invest in an indoor air filtration system to ensure no fungi enter your house through the air.
- Keep your skin injuries free of dirt and dust to make sure no fungi have the opportunity to turn into an infection that may lead to further complications.
- If you do develop a fungal infection, take the necessary anti-fungal medication religiously to prevent the spread of infection to the central nervous system.
Now that you have all the basic information on the symptoms, causes and treatments of fungal meningitis, you may be able to determine your next course of action. If you experience fungal meningitis symptoms, call your doctor at the earliest.