Fungal meningitis is rare, however the most common cause is Cryptococcus spp. infection, but many other fungi may occasionally cause meningitis.
Fungal meningitis is not transmitted from person to person. The fungi are usually inhaled and then spread by the blood to the central nervous system; fungi may also be directly inserted into the central nervous system by medical techniques or enter from an infected site near the central nervous system to cause meningitis.
Fungal meningitis is rare and usually the result of spread of a fungus through blood to the spinal cord. Although anyone can get fungal meningitis, people with weakened immune systems, like those with HIV infection or cancer, are at higher risk.
The most common cause of fungal meningitis for people with weakened immune systems is Cryptococcus. This disease is one of the most common causes of adult meningitis in Africa.
You may also get fungal meningitis after taking medications that weaken your immune system. Examples of these medications include steroids (such as prednisone), medications given after organ transplantation, or anti-TNF medications, which are sometimes given for treatment of rheumatoid arthritis or other autoimmune conditions.
Different types of fungus are transmitted in several ways. Cryptococcus is thought to be acquired through inhaling soil contaminated with bird droppings, and Histoplasma is found in environments with heavy contamination of bird or bat droppings. Blastomyces is thought to exist in soil rich in decaying organic matter. Coccidioides is found in the soil of endemic areas. When these environments are disturbed, the fungal spores can be inhaled. Meningitis results from the fungal infection spreading to the spinal cord. Candida is usually acquired in a hospital setting.
Fungal meningitis is treated with long courses of high dose antifungal medications, usually given through an IV line in the hospital. The length of treatment depends on the status of the immune system and the type of fungus that caused the infection. For people with immune systems that do not function well because of other conditions, like AIDS, diabetes or cancer treatment is often longer.
No specific activities are known to cause fungal meningitis. Avoid soil and other environments that are likely to contain fungus. People with weakened immune systems (for example, those with HIV infection) should try to avoid bird droppings and avoid digging and dusty activities, particularly if they live in a geographic region where fungi like Histoplasma, Coccidioides, or Blastomyces species exist. HIV-infected people cannot completely avoid exposure.