Key points
- Fungal meningitis is a rare fungal infection of the membranes (meninges) around the brain and spinal cord.
- It most often occurs in people with weakened immune systems and is caused by fungi inhaled from the environment.
- Rarely, fungal meningitis can happen in people with no underlying medical conditions because of contamination during medical procedures, such as spinal injections or surgeries.
- Learn more about the symptoms, risks factors, testing, and treatment.
What it is
Fungal meningitis is a very rare but life-threatening infection that causes swelling in the membranes around the brain and spinal cord.
In people with weakened immune systems, a fungal infection can start in another part of the body and then spread to the areas around the brain and spinal cord. For example, inhaling fungal spores from the environment can lead to a lung infection, which may subsequently spread and result in fungal meningitis.
Some fungi that can cause infections leading to fungal meningitis include:
Associated with medical procedures
Rarely, people can develop fungal meningitis as a result of medical procedures if proper infection control practices are not taken. This can affect people with or without weakened immune systems. Contaminated medications or medical equipment can introduce fungi into the brain or spinal cord. This risk can be associated with various types of fungi, and it shows the importance of strict adherence to infection prevention protocols during medical interventions.
Fungal meningitis outbreak
Symptoms
People with fungal meningitis may start off with mild symptoms that develop into typical meningitis symptoms, including:
- fever
- headache
- stiff neck
- nausea
- vomiting
- light sensitivity
- confusion
When to seek emergency care
Risk factors
Anyone can get fungal meningitis, but some people are at increased risk.
Typically, only people with weakened immune systems develop fungal meningitis. Certain health conditions (like advanced HIV disease and cancer), medications, and surgical procedures may weaken the immune system. Medications that can weaken the immune system include:
- Steroids (such as prednisone)
- Medicines given after organ transplantation
- Anti-tumor necrosis factor (TNF) medicines
Anti-TNF medicines are sometimes given to treat rheumatoid arthritis or other autoimmune conditions.
Who is at risk
Premature babies with very low birth weights are at increased risk for getting Candida bloodstream infection. These infections can spread to the brain.
Living in certain areas of the United States may increase the risk for fungal lung infections. These infections can spread to the brain or spinal cord.
People who have surgical procedures can get fungal meningitis, but it is very rare.
How it spreads
From the environment
Many fungi that can cause meningitis live in the environment. People can get sick if they breathe in fungal spores.
From inside and on the body
Candida normally lives inside the gut and on the skin without causing any problems. However, Candida can enter the bloodstream or internal organs and cause an infection.
Associated with healthcare procedures
While rare, outbreaks of fungal meningitis following medical and surgical procedures have occurred. People can get infected during medical procedures if all infection control practices aren't followed or if a source of medication is contaminated.
How it doesn't spread
Fungal meningitis doesn't spread between people.
Reducing risk
People with weak immune systems can take steps to reduce their risk. This is especially important for those who live in areas where these fungi are found.
Avoid exposure to dust and dirt
Try to avoid areas with a lot of dust like construction or excavation sites. If they're unavoidable, wear an N95 respirator (a type of face mask) while there.
- Stay inside during dust storms and close windows.
- Avoid activities that involve close contact with dirt or dust.
Use proper wound care
Clean skin injuries well with soap and water to reduce the chances of developing a skin infection. This is especially important if the wound was exposed to dirt or dust.
Take precautions if you're seeking health care abroad
If you're planning to get health care abroad, research the healthcare facilities and providers in the area to ensure they meet safety and quality standards. Also, consider obtaining travel insurance that covers medical expenses and check if any vaccinations or health precautions are recommended for the destination.
Other prevention strategies
- Use air filtration measures indoors.
- Take preventive antifungal medication if prescribed.
Testing and diagnosis
There are laboratory tests for meningitis. Tests might include a spinal tap, where a long needle collects fluid from around the spine for testing. The fluid around the spine may be sent to the lab to look for signs of infection, such as specific proteins or pieces of fungi. Doctors may also test for beta-D-glucan (BDG), a substance that can appear in the blood when there is a fungal infection.
Treatment and recovery
Healthcare providers treat fungal meningitis with high-dose antifungal medicines, often given directly into a vein through an IV catheter. After that, people also need to take antifungal medicines by mouth.
The total length of treatment depends on each person's immune system and the type of fungus causing the infection. Treatment is often longer for people with weak immune systems and might be lifelong.
