Nursing Management of Lumbar Drainage in Cryptococcal Meningitis: A Case Report

Raised intracranial pressure is a hallmark of cryptococcal meningitis and is associated with increased mortality. Continuous drainage of lumbar cerebrospinal fluid is suggested to control intracranial pressure. The complications induced by this treatment have been described. However, nursing care associated with identification and management of complications is less well known. We encountered a patient with human immunodeficiency virus-negative cryptococcal meningitis who developed increasing cerebrospinal fluid pressure, hearing impairment, and limb weakness. The patient's symptoms improved significantly by antifungal therapy and continuous lumbar drainage. Nurses play a vital role in monitoring patients with lumbar drainage for complications and to maintain integrity of the system. The nursing role in this approach is discussed with particular emphasis on recognition of complications and responses toward immediate emergent intervention.