Cryoptococcal meningitis

January 2007     View PDF     En español

How can I tell if I have cryptococcal meningitis?

Many of the symptoms of meningitis are the same as other common infections including the flu. Sometimes, however, cryptococcal meningitis may present as nothing more than the worst headache of a person’s life. Also, because these symptoms may appear slowly and gradually, it can be difficult for a person living with HIV to know for certain if they are ill with cryptococcal meningitis or something else. If you are experiencing confusion, disorientation, severe headache or seizures you should contact a healthcare provider immediately and/or consider going to an emergency room. However, it may also be advisable to contact your healthcare provider if you experience any of the following symptoms for three or more days in a row:

• Moderate to high fever (over 100°)
• Nausea
• Vomiting
• Severe body aches, especially of the neck
• Irritation to the eyes from bright light

Normally your healthcare provider will confirm a diagnosis of cryptococcal meningitis through either a simple blood test or a procedure called a lumbar puncture (also called a spinal tap). During a spinal tap, a needle is inserted in the middle of your back just above your hips. The needle removes a sample of your spinal fluid for testing. Although a lumbar puncture may sound frightening to some people, it is a very common procedure, and permanent bodily harm is extremely rare. To reduce discomfort, your doctor will inject an anesthetic (a numbing medicine) into the area before inserting the needle. A common side effect of a lumbar puncture is a headache that may last for several days. Some people are able to avoid or decrease the severity of the headaches by lying down for one or two hours immediately following the procedure.

The blood or spinal fluid is then tested. One of the most accurate and sensitive tests involves looking for Cryptococcus in the blood or spinal fluid. This test, called a CRAG test, is able to detect about 95% of people who are ill with cryptococcal meningitis. Meningitis can also be caused by different kinds of bacterial infection. If your healthcare provider thinks that you may have bacterial meningitis you will normally be treated with antibiotics immediately while other tests, such as the CRAG test, are performed. This is because bacterial meningitis is deadly and progresses very rapidly without antibiotic treatment.