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Related Experiment Videos

Fungal meningitis.

C B Treseler1, A M Sugar

  • 1Section of Infectious Diseases, Evans Memorial Department of Clinical Research, Boston University Medical Center, Massachusetts.

Infectious Disease Clinics of North America
|December 1, 1990
PubMed
Summary
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Medical mycology·2000

Fungal meningitis, though often chronic, can be fatal. Pathogenic fungi spread via inhalation or dissemination, affecting the central nervous system (CNS) primarily in immunosuppressed hosts.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Neurology

Background:

  • Fungal meningitis presents as a subacute or chronic condition, potentially as lethal as bacterial meningitis if untreated.
  • Pathogenic fungi share similarities, often initiating infection through inhalation leading to pulmonary disease, followed by potential hematogenous dissemination to the central nervous system (CNS).
  • Immunosuppression is a frequent, though not universal, host factor in fungal meningitis.

Purpose of the Study:

  • To review the pathogenesis, diagnosis, and treatment of fungal meningitis.
  • To highlight the differences in disease presentation between fungal molds and yeasts.
  • To discuss current and emerging antifungal treatment strategies.

Main Methods:

  • Review of existing literature on fungal meningitis.

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  • Analysis of pathogenic mechanisms and clinical presentations.
  • Evaluation of diagnostic challenges and therapeutic options.

    • Main Results:

    • Molds typically cause focal CNS disease with necrosis, while yeasts lead to diffuse inflammation, often at the brain base, causing hydrocephalus.
    • Diagnosis can be challenging, with cerebrospinal fluid (CSF) sometimes showing normal results, negative smears, and sterile cultures.
    • Serological tests and travel history can aid diagnosis, with amphotericin B remaining a primary treatment, and newer azoles showing promise, particularly for cryptococcal meningitis.

    Conclusions:

    • Fungal meningitis requires careful diagnosis and management, considering the specific fungal pathogen and host factors.
    • While amphotericin B is standard, newer azole antifungals represent a promising advancement, especially for specific types like cryptococcal meningitis.
    • Further large-scale studies are needed to clarify the role of novel azoles in treating central nervous system mycoses.