Cryoptococcal meningitis

January 2007     View PDF     En español

Cryptococcal meningitis (crip-toe-CAWK-kull men-in-JYE-tis) is an inflammation and swelling of the brain and spinal cord tissues, caused by a fungus called Cryptococcus neoformans. This inflammation is dangerous and leads to death in nearly all people who are not treated. Treatments do exist, however, and are quite effective.

Cryptococcal meningitis is not very common. It is rare in people with CD4+ cell counts above 100. When it does occur, it typically strikes in people with compromised immune systems, usually when CD4+ cell counts falls below 50. It does also occur, though rarely, in people who are otherwise healthy and not living with HIV.

The fungus that causes cryptococcal meningitis is common in dirt and dust, especially in dirt containing bird droppings. People are normally infected when they breathe in dirt that contains the organism Cryptococcus. In healthy individuals, this infection is usually contained in the lungs and never causes disease. Scientists believe that most cases of cryptococcal disease are caused by a reactivation of previous infection rather than a new infection. However, it is wise for people living with HIV to avoid bird roosts and other places where they may come into contact with large amounts of bird droppings.

Cryptococcus can cause other conditions, such as lung infections, which can lead to pneumonia. Outside of the lungs and the Central Nervous System (CNS), Cryptococcus can infect the kidneys, bone marrow, urinary tract, lymph nodes and the skin. When the infection spreads beyond the lungs and CNS, it is called disseminated (spread out) infection. When a person experiences disseminated infection, the most common appearance is skin lesions. These lesions may look quite different from one person to another, and can even look a lot like other common skin conditions such as molluscum or herpes. The lesions occur in about 10% of all people who are later diagnosed with cryptococcal meningitis and are sometimes the first sign that a person may have Cryptococcus-related disease.

Common symptoms of meningitis:
     fever
     fatigue
     stiff neck
     headache
     nausea
     vomiting
     confusion/disorientation
     vision problems
     skin lesions