Cryptococcal meningitis

Cryptococcal meningitis is an infection of the membranes surrounding the brain and spinal cord caused by the encapsulated yeast Cryptococcus neoformans. It most commonly affects individuals with compromised immune systems, such as those with acquired immunodeficiency syndrome. The infection typically begins in the lungs after inhalation of the yeast and may subsequently involve the central nervous system. Prevalence details are not well established with specific estimates currently unavailable.

Patients with cryptococcal meningitis often present with a subacute onset of headache, nausea, and sensitivity to light, along with focal neurological deficits. Some individuals experience seizures, cranial nerve abnormalities, and hydrocephalus, while lung involvement is common initially and parenchymal brain lesions (torulomas) can occur. Not all individuals experience all features, and severity varies considerably.

Cryptococcal meningitis is caused by an infection with the encapsulated yeast Cryptococcus neoformans. The organism typically enters the body through the respiratory tract, and individuals with weakened immune defenses are particularly susceptible to developing the infection. The condition is not inherited, and the precise role of genetic factors in immune response remains under investigation.

Currently, management of cryptococcal meningitis focuses on supportive care and symptom management, with treatment plans tailored to the individual. A multidisciplinary team often addresses both the neurological complications and the underlying state of immunosuppression. Although investigational therapies exist, there are no specific approved treatments for this condition, so patients are encouraged to discuss potential options with their healthcare team. Genetic counseling is not applicable, but consultation with specialists experienced in managing severe infections can be beneficial.

Outcomes for cryptococcal meningitis vary widely depending on the severity of the infection, the patient's immune status, and how quickly treatment is initiated. With current standards of care, many individuals experience stabilization of symptoms, although the overall course can be highly variable. Outcomes described in medical literature continue to evolve as standards of care improve. Families often find it helpful to connect with specialists familiar with managing severe infections and immunocompromised conditions.

There is ongoing research into new therapeutic approaches for cryptococcal meningitis, with several clinical trials currently investigating novel treatment options. Individuals interested in clinical trials can search ClinicalTrials.gov or consult their care team about eligibility.