Fungal Meningitis: Types, Symptoms, and Treatment

We usually associate microorganisms that cause disease with bacteria and viruses, but a fungus may also play a role. The bloodstream is an entry point for fungi to the central nervous system, which includes the brain and spinal cord. As a result, the protective membrane surrounding the brain and spinal cord may become inflamed, resulting in fungal meningitis. Fungal meningitis is uncommon and not contagious, even though it may have devastating effects.

Nevertheless, like bacterial meningitis, it may produce outbreaks, like the one in 2012 that killed more than 50 people and sickened hundreds more when steroid injections were tainted with the fungus Exserohilum rostratum.

What is Fungal Meningitis?

If a fungal infection elsewhere in the body can migrate to the brain or spinal cord, a condition known as fungal meningitis may develop.

In certain places of the globe, the fungi that cause fungal meningitis are naturally present in the environment. Most individuals will be unaffected or just mildly affected by exposure to these fungi. Yet, those with compromised immune systems face a different outlook.

Meningitis is caused by a fungal infection that may spread from person to person.

Infection Of The Meninges Due To Fungi

Tiny, airborne microorganisms are to blame for fungal meningitis. Little spores of fungus may lodge in the lungs and cause an illness. Fungal meningitis may occur if the infection progresses to the membranes surrounding the brain and spinal cord.

Combating fungal meningitis with routine hygiene measures is challenging. If your immune system is compromised, you should exercise particular care while engaging in activities that connect you with fungi that might cause meningitis.

A compromised immune system might result from a chronic illness like cancer or HIV to a temporary infection like the flu (flu). The immune system may be suppressed postoperatively or when taking certain medications.

As an example −

  • After an organ transplant, patients may take certain medications.

  • Medication that blocks TNF is used to treat rheumatoid arthritis and other autoimmune diseases.

  • Steroids are used to treat lupus, asthma, or inflammatory bowel disease.

If a person breathes in fungal spores, they may get trapped inside their blood vessels. Little fungal spores may invade blood arteries and cause them to enlarge and explode. Meningitis, an infection of the meninges surrounding the brain, may result from this.


When a fungal infection elsewhere in the body travels to the brain or spinal cord, it is called fungal meningitis. Fungal meningitis may be caused by many distinct species of fungus (Reliable Source).

Cryptococcus Neoformans

This fungus, Cryptococcus neoformans, is ubiquitous and may be found in soils all around the globe.


Histoplasma fungus is widespread, particularly in areas with high bat or bird guano concentrations. The healthy host is unaffected, but those with compromised immune systems are at risk for developing fungal meningitis.


Blastomyces is a fungus that thrives in shady, moist places, such as wet soil, rotting wood, or fallen leaves. The southern, central, and southeastern areas of the United States and the Midwest are the most common places to see this fungus.


Soil fungus Coccidioides is found in the southern United States and south-central Washington. Its range extends into Mexico, Central America, and South America.


Candida is a fungus that may cause infections both on the skin and within the body. Candida typically doesn't cause any issues, but in those susceptible to this fungus entering their bloodstream or internal organs, it may cause meningitis.


Although fungal meningitis is uncommon, its symptoms are sometimes identical to those of more common types of meningitis.

Fungal meningitis may manifest with the following signs and symptoms −

  • Sore neck

  • Overheating or fever

  • Headache

  • Feeling nauseous and nauseated

  • The heightened sensitivity of your eyes to light (photophobia)

  • Disorientation or a messy head

Although fungal meningitis cannot be passed from person to person, it may have severe consequences for those who get it. Because of this, getting a diagnosis as soon as possible is crucial.


Doctors often prescribe very high doses of antifungal medicine to treat fungal meningitis. Antifungal treatment for humans usually involves many pills taken daily. They can start off with an IV and then switch to oral medications.

The severity of an illness and its kind of fungus might influence the choice of antifungal medicine. Many antifungal drugs are available for the medical treatment of a Cryptococcus infection.

  • Antifungal drug amphotericin B (Fungizone)

  • Flucytosine (Ancobon)

  • Fluconazole (Diflucan)

In cases of Histoplasma infection, the antifungal drug itraconazole may be prescribed (Sporanox). Patients' immune systems and the severity of their fungal infection will determine how long they will need to take this medicine.

If the Blastomyces infection is not too severe, your doctor may prescribe itraconazole. Amphotericin B may be required for patients with very harsh conditions. Those infected with Blastomyces may need therapy for a period ranging from 6 months to a year. Individuals may need lifetime therapy with antifungal medicine if the Coccidioides fungus is found to be the cause of the illness. Doctors may prescribe antifungal drugs like fluconazole.

Echinocandins, antifungal medicines, are administered intravenously to treat a Candida infection. When treating fungal meningitis, it may take anything from a few weeks to a few months, depending on the patient and the fungus at hand. It may be necessary to continue therapy for longer in those whose immune systems are compromised. Treatment for maintenance purposes may be required for certain patients. It implies they'll have to keep taking antifungal drugs for a long time, if not forever.


Since fungal meningitis is more likely to infect people with compromised immune systems, such people must always be cautious about their health. Preventing the onset of any future health problems or diseases requires, among other things, limiting or avoiding contact with any potentially infectious agents.

Fungal meningitis is uncommon and poses little risk to the general population. Nevertheless, those with compromised immune systems must take precautions to avoid contact with potentially harmful fungal spores and seek prompt medical attention if they have any signs of fungal meningitis.

Updated on: 03-Apr-2023


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