Fungal Meningitis: Symptoms, Causes & Diagnosis

Updated in July 2023

Fungal meningitis is an infectious disease caused by fungus that causes inflammation of the meninges. These are membranes that surround and protect the brain and spinal cord, and are susceptible to infectious agents. Inflammation of these membranes can lead to symptoms like headache, fever, nausea and vomiting. 

This type of meningitis is very rare, but can occur in anyone, particularly in those with a weakened immune system. Fungal meningitis can be caused by different types of fungus, although most infections are caused by fungus of the Cryptococcus species. 

Common symptoms

The main symptoms of fungal meningitis are: 

  • Fever
  • Intense headache
  • Nausea
  • Vomiting
  • Pain when moving the neck
  • Light sensitivity
  • Hallucinations
  • Altered level of consciousness 

In some cases. meningitis that is not adequately treated can lead to complications like seizures, brain damage or even death. 

Common causes

Fungal meningitis typically occurs as a result of an untreated fungal infection. These fungi can spread through the blood stream and cross the blood-brain barrier, making their way into the brain and spinal cord. 

Although it is rare, this condition is more likely to occur in people with a weakened immune system (from HIV, for example), in people undergoing cancer treatment or in those taking medications like immunosuppressants or corticosteroids.

Generally the fungus that causes fungal meningitis belong to the Cryptococcus species. This fungus can be found in soil, bird excrement and rotting wood. Other fungi that can also cause fungal meningitis include Histoplasma sp, Blastomyces sp., Coccidioides sp. and Candida sp. 

Confirming a diagnosis

Diagnosis is confirmed based on the results of blood work, CSF testing and imaging tests (like CT and MRI), which help to identify possible inflammation surrounding the brain. 

Is fungal meningitis contagious?

Fungal meningitis is not transmitted through person-to-person. This infection is spread through inhalation of fungal spores released in the environment. Fungal meningitis can also be contracted from medical equipment that has not undergone proper sterilization, and from contaminated medication that is not adequately handled, although these situations are more rare. 

Treatment options

Treatment for fungal meningitis should be guided by an infectious disease specialist, and typically involves IV antifungals like amphotericin V, fluconazole, flucytosine or itraconazole. These should be administered in a hospital setting so that the patient's symptoms and therapeutic efficacy can be continuously monitored.