Cryptococcal meningitis
So far, we only often hear about meningitis, which is an infection of the protective membranes surrounding the brain and spinal cord (meninges). This infection can affect anyone, but it is most common in infants, young children, adolescents, and young adults. Meningitis can become a serious condition if not treated quickly. But some time ago there was a type of meningitis called "Cryptococcal Meningitis", of course, this is a concern about what this disease is.
What is cryptococcal meningitis?
Cryptocurrency is a mushroom. These germs are very prevalent in the soil. This fungus enters our body when we inhale dust or dried bird droppings. It seems that these germs do not spread from person to person.
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Meningitis is an infection of the lining of the spinal cord and brain. Meningitis can be caused by different types of infections. The disease can lead to coma and death. Meningitis is the most common disease caused by cryptococcus.
Cryptococcus can also infect the skin, lungs, and other parts of the body. The risk of cryptococcal infection is highest if the CD4 cell count is below 50. Cryptococcal meningitis is one of the most important HIV-related opportunistic infections, especially in developing countries. A new study estimates there are one million cases each year.
The first signs of meningitis include fever, fatigue, neck aches, headache, nausea and vomiting, confusion, blurred vision, and sensitivity to bright light. This symptom appears slowly. Headaches are often experienced in the front of the head and are unable to be relieved by paracetamol.
HIV disease or medications can also cause similar symptoms. So, laboratory tests are used to determine the diagnosis of meningitis.
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This laboratory test uses blood or spinal cord fluid. Spinal cord fluid is taken by a process called lumbar puncture or spinal tap. A needle is inserted in the middle of our spine, just above the hip. The needle sucks a sample of spinal cord fluid. Spinal cord fluid pressure can also be measured. If the pressure is too high, some of the liquid can be sucked out. This test is safe and usually less painful. But after a lumbar puncture, some people experience headaches, which can last several days.
Blood or spinal cord fluid can be tested for cryptococcus in two ways. A test called 'CRAG' looks for an antigen (a protein) made by cryptococcus. The 'culture' test attempts to grow cryptococcal fungi from a sample of liquid. The CRAG test is quick and can give results on the same day. Culture tests take a week or more to show a positive result. Spinal cord fluid can also be tested quickly when stained with Indian ink.
How is cryptococcal meningitis treated?
Cryptococcal meningitis is treated with antifungal drugs. Some doctors take fluconazole. The drug is available in pill or infusion form. Fluconazole is fairly effective, and usually easily withstood (see Fact Sheet 534). Itraconazole is sometimes used for people who cannot stand fluconazole. Other doctors choose a combination of amphotericin B and flucytosine capsules.
Amphotericin B is a very potent drug. This medicine is injected or infused slowly and can cause severe side effects. These side effects can be reduced by taking a drug such as ibuprofen half an hour before amphotericin B is used. There is a new version of amphotericin B, with the drug-coated in fatty membranes into tiny bubbles called liposomes. This version might cause fewer side effects. Cryptococcal meningitis recurs after the first occurrence in approximately half of people. The chance of relapse can be reduced by continuing to take antifungal medications. But a new study found that meningitis did not recur in people with HIV with CD4 counts rising to more than 100 and having an undetectable viral load for three months.
For some people, spinal cord fluid must be aspirated daily for some time to relieve pressure on the brain.
People with HIV/AIDS who start antiretroviral therapy (ART) after being infected with cryptococcus may experience these symptoms as part of immune restoration syndrome (IRIS: see Fact Sheet 483). A 2011 study showed that starting ART while treating cryptococcal meningitis increased the risk of IRIS. Better results are achieved by treating such meningitis before starting ART.
How can we choose treatment?
If you have cryptococcal meningitis, you are treated with antifungal medications such as amphotericin B, fluconazole, and flucytosine. Amphotericin B is the most potent, but it can damage the kidneys. Other drugs result in milder side effects but are less effective at eradicating cryptocurrency.
If meningitis is diagnosed early enough, the disease can be treated without taking amphotericin B. However, a common treatment is amphotericin B for two weeks followed by oral fluconazole (pills). Without ART, fluconazole must be taken continuously for life; Otherwise, meningitis is likely to recur. If you are taking ART, you can stop taking fluconazole if your CD4 cell count remains above 200 for more than six months.
Can cryptococcal meningitis be prevented?
Taking fluconazole when the CD4 cell count is below 50 can help prevent cryptococcal meningitis.
Hope this information about "Cryptococcal Meningitis" is useful.