Cryoptococcal meningitis

January 2007     View PDF     En español

The bottom line

If you think you have cryptococcal meningitis:

• Report symptoms to your healthcare provider immediately! Untreated meningitis is usually fatal.
• Simple lab tests should be performed to give a firm diagnosis of cryptococcal meningitis.
• If your healthcare providers suspects you have bacterial meningitis you should be prescribed antibiotics while you wait for lab results.

If you have been diagnosed with cryptococcal meningitis:

• For moderate CM, simple treatment with fluconazole is highly effective and generally well tolerated among people who have previously not been on long-term fluconazole therapy.
• For people with long-term previous use of fluconazole or with severe CM, amphotericin-based therapies are the drug of choice.
• Newer liposomally encapsulated formulations of amphotericin B are effective and available for people who cannot tolerate standard amphotericin B.
• Once treated for CM, fluconazole maintenance therapy may be necessary for life.
• Flucytosine and fluconazole should not be used by pregnant women due to potential harm to her unborn child.

If you want to prevent cryptococcal meningitis:

• Primary prevention of CM generally discouraged, as the overall incidence is low and preventive drugs may become ineffective as treatment later.