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cryptococcal meningitisNeurology An opportunistic infection of the meninges and spinal cord by Cryptococcus neoformans At-risk Pts AIDS, lymphoma, DM Clinical Severe headache, confusion, photosensitivity, blurred vision, fever, speech difficulties Management Amphotericin B plus flucytosine, then consolidation with fluconazole or itraconazole Prognosis Untreated, coma, death
Fungal meningitis due to Cryptococcus neoformans. A rare cause of disease in healthy hosts, cryptococcal meningitis is an opportunistic infection usually seen in patients with advanced AIDS or patients taking high-dose steroids. It usually presents with gradually progressive headache and fever. The serum cryptococcal antigen test is a useful screening test. The diagnosis is established by the results of analysis and culture of cerebral spinal fluid.
Treatment options include amphotericin B, often with flucytosine. Fluconazole and/or related antifungals are sometimes used for maintenance therapy.
See also: meningitis