Fungal meningitis history and symptoms: Difference between revisions

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==Overview==
==Overview==
Fungal meningitis can occur in two main clinical pictures: subacute meningitis and chronic meningitis. Chronic meningitis is characterized by the presence of symptoms for more than four weeks.
Fungal meningitis can occur in two main clinical pictures: [[subacute]] meningitis and [[chronic]] meningitis. Chronic meningitis is characterized by the presence of symptoms for more than four weeks. Commonly, patients with fungal meningitis have a history of one or more of the following chronic [[sinusitis]], [[granulocytopenia]], [[Chronic renal failure|chronic renal failure,]] [[diabetes]], [[pregnancy]], [[IV drug abusers|IV drug abuse]], prolonged [[intravenous]] therapy, exposure history example travel to or residence inendemic regions of the pathogen, immune suppression examples systemic neoplasia, organ transplantation, [[Human Immunodeficiency Virus|Human immunodeficiency virus]] ([[Human Immunodeficiency Virus (HIV)|HIV]]) / [[acquired immunodeficiency syndrome]] ([[AIDS]]), water [[aspiration]] as in a case of Pseudoallescheria boydii and traumatic inoculation as in a case of [[Sporothrix schenckii]]. On presentation patients may have the following symptoms, [[headache]], [[neck stiffness]], [[fever]], [[fatigue]], [[night sweats]], [[cranial nerves]] involvement,<ref name=":0" /> [[hydrocephalus]], c[[Cranial neuropathy|ranial neuropathy]], [[radiculopathy]] and cognitive and personality changes.<ref name=":0">Roos KL, Tyler KL. Chapter 381. Meningitis, Encephalitis, Brain Abscess, and Empyema. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J,  eds. Harrison's Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2012.</ref>


==History==
==History==
Commonly patients have a history of one or more of the following:<ref name="pmid26392507">{{cite journal| author=Morgand M, Rammaert B, Poirée S, Bougnoux ME, Tran H, Kania R et al.| title=Chronic Invasive Aspergillus Sinusitis and Otitis with Meningeal Extension Successfully Treated with Voriconazole. | journal=Antimicrob Agents Chemother | year= 2015 | volume= 59 | issue= 12 | pages= 7857-61 | pmid=26392507 | doi=10.1128/AAC.01506-15 | pmc=4649149 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26392507  }} </ref><ref name="pmid17921648">{{cite journal| author=Shankar SK, Mahadevan A, Sundaram C, Sarkar C, Chacko G, Lanjewar DN et al.| title=Pathobiology of fungal infections of the central nervous system with special reference to the Indian scenario. | journal=Neurol India | year= 2007 | volume= 55 | issue= 3 | pages= 198-215 | pmid=17921648 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17921648  }} </ref><ref name="pmid12751260">{{cite journal| author=Chiller TM, Galgiani JN, Stevens DA| title=Coccidioidomycosis. | journal=Infect Dis Clin North Am | year= 2003 | volume= 17 | issue= 1 | pages= 41-57, viii | pmid=12751260 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12751260  }} </ref><ref name="pmid11429020">{{cite journal| author=Singh N, Husain S| title=Infections of the central nervous system in transplant recipients. | journal=Transpl Infect Dis | year= 2000 | volume= 2 | issue= 3 | pages= 101-11 | pmid=11429020 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11429020  }} </ref><ref name="pmid11229838">{{cite journal| author=Rosenstein NE, Emery KW, Werner SB, Kao A, Johnson R, Rogers D et al.| title=Risk factors for severe pulmonary and disseminated coccidioidomycosis: Kern County, California, 1995-1996. | journal=Clin Infect Dis | year= 2001 | volume= 32 | issue= 5 | pages= 708-15 | pmid=11229838 | doi=10.1086/319203 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11229838  }} </ref><ref name="pmid11051295">{{cite journal| author=Gottfredsson M, Perfect JR| title=Fungal meningitis. | journal=Semin Neurol | year= 2000 | volume= 20 | issue= 3 | pages= 307-22 | pmid=11051295 | doi=10.1055/s-2000-9394 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11051295  }} </ref><ref name="pmid480580">{{cite journal| author=Fraser DW, Ward JI, Ajello L, Plikaytis BD| title=Aspergillosis and other systemic mycoses. The growing problem. | journal=JAMA | year= 1979 | volume= 242 | issue= 15 | pages= 1631-5 | pmid=480580 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=480580  }} </ref><ref name="pmid7004196">{{cite journal| author=Perfect JR, Lang SD, Durack DT| title=Chronic cryptococcal meningitis: a new experimental model in rabbits. | journal=Am J Pathol | year= 1980 | volume= 101 | issue= 1 | pages= 177-94 | pmid=7004196 | doi= | pmc=1903580 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7004196  }} </ref><ref name="pmid3992427">{{cite journal| author=Perfect JR, Durack DT| title=Chemotactic activity of cerebrospinal fluid in experimental cryptococcal meningitis. | journal=Sabouraudia | year= 1985 | volume= 23 | issue= 1 | pages= 37-45 | pmid=3992427 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3992427  }} </ref><ref name="pmid3899932">{{cite journal| author=Perfect JR, Durack DT| title=Effects of cyclosporine in experimental cryptococcal meningitis. | journal=Infect Immun | year= 1985 | volume= 50 | issue= 1 | pages= 22-6 | pmid=3899932 | doi= | pmc=262129 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3899932  }} </ref><ref name="pmid3275587">{{cite journal| author=Mody CH, Toews GB, Lipscomb MF| title=Cyclosporin A inhibits the growth of Cryptococcus neoformans in a murine model. | journal=Infect Immun | year= 1988 | volume= 56 | issue= 1 | pages= 7-12 | pmid=3275587 | doi= | pmc=259224 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3275587  }} </ref>
Commonly, patients with fungal meningitis have a history of one or more of the following:<ref name="pmid26392507">{{cite journal| author=Morgand M, Rammaert B, Poirée S, Bougnoux ME, Tran H, Kania R et al.| title=Chronic Invasive Aspergillus Sinusitis and Otitis with Meningeal Extension Successfully Treated with Voriconazole. | journal=Antimicrob Agents Chemother | year= 2015 | volume= 59 | issue= 12 | pages= 7857-61 | pmid=26392507 | doi=10.1128/AAC.01506-15 | pmc=4649149 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26392507  }} </ref><ref name="pmid17921648">{{cite journal| author=Shankar SK, Mahadevan A, Sundaram C, Sarkar C, Chacko G, Lanjewar DN et al.| title=Pathobiology of fungal infections of the central nervous system with special reference to the Indian scenario. | journal=Neurol India | year= 2007 | volume= 55 | issue= 3 | pages= 198-215 | pmid=17921648 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17921648  }} </ref><ref name="pmid12751260">{{cite journal| author=Chiller TM, Galgiani JN, Stevens DA| title=Coccidioidomycosis. | journal=Infect Dis Clin North Am | year= 2003 | volume= 17 | issue= 1 | pages= 41-57, viii | pmid=12751260 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12751260  }} </ref><ref name="pmid11429020">{{cite journal| author=Singh N, Husain S| title=Infections of the central nervous system in transplant recipients. | journal=Transpl Infect Dis | year= 2000 | volume= 2 | issue= 3 | pages= 101-11 | pmid=11429020 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11429020  }} </ref><ref name="pmid11229838">{{cite journal| author=Rosenstein NE, Emery KW, Werner SB, Kao A, Johnson R, Rogers D et al.| title=Risk factors for severe pulmonary and disseminated coccidioidomycosis: Kern County, California, 1995-1996. | journal=Clin Infect Dis | year= 2001 | volume= 32 | issue= 5 | pages= 708-15 | pmid=11229838 | doi=10.1086/319203 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11229838  }} </ref><ref name="pmid11051295">{{cite journal| author=Gottfredsson M, Perfect JR| title=Fungal meningitis. | journal=Semin Neurol | year= 2000 | volume= 20 | issue= 3 | pages= 307-22 | pmid=11051295 | doi=10.1055/s-2000-9394 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11051295  }} </ref><ref name="pmid480580">{{cite journal| author=Fraser DW, Ward JI, Ajello L, Plikaytis BD| title=Aspergillosis and other systemic mycoses. The growing problem. | journal=JAMA | year= 1979 | volume= 242 | issue= 15 | pages= 1631-5 | pmid=480580 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=480580  }} </ref><ref name="pmid7004196">{{cite journal| author=Perfect JR, Lang SD, Durack DT| title=Chronic cryptococcal meningitis: a new experimental model in rabbits. | journal=Am J Pathol | year= 1980 | volume= 101 | issue= 1 | pages= 177-94 | pmid=7004196 | doi= | pmc=1903580 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7004196  }} </ref><ref name="pmid3992427">{{cite journal| author=Perfect JR, Durack DT| title=Chemotactic activity of cerebrospinal fluid in experimental cryptococcal meningitis. | journal=Sabouraudia | year= 1985 | volume= 23 | issue= 1 | pages= 37-45 | pmid=3992427 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3992427  }} </ref><ref name="pmid3899932">{{cite journal| author=Perfect JR, Durack DT| title=Effects of cyclosporine in experimental cryptococcal meningitis. | journal=Infect Immun | year= 1985 | volume= 50 | issue= 1 | pages= 22-6 | pmid=3899932 | doi= | pmc=262129 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3899932  }} </ref><ref name="pmid3275587">{{cite journal| author=Mody CH, Toews GB, Lipscomb MF| title=Cyclosporin A inhibits the growth of Cryptococcus neoformans in a murine model. | journal=Infect Immun | year= 1988 | volume= 56 | issue= 1 | pages= 7-12 | pmid=3275587 | doi= | pmc=259224 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3275587  }} </ref>


**Chronic [[sinusitis]]
*[[sinusitis|Chronic sinusitis]]
**[[Granulocytopenia]]
*[[Granulocytopenia]]
**[[Chronic renal failure]]
*[[Chronic renal failure]]
**[[Diabetes]]
*[[Diabetes]]
** [[Pregnancy]]
* [[Pregnancy]]
**Persons with [[diabetes]] 
*[[IV drug abusers|IV drug abuse]]
**[[IV drug abusers|IV drug abuse]]
*Prolonged [[intravenous]] therapy
**Prolonged [[intravenous]] therapy
*Exposure history for example: travel to or residence in endemic regions of the pathogen
**Exposure history example travel to or residence inendemic regions of the pathogen
*[[Immunosuppression|Immune suppression]] status, such as [[neoplasia|systemic neoplasia]], [[Organ transplant|organ transplantation]], [[Human Immunodeficiency Virus|Human immunodeficiency virus]] ([[Human Immunodeficiency Virus (HIV)|HIV]]) / [[acquired immunodeficiency syndrome]] ([[AIDS]]),  
**Immune suppression examples systemic neoplasia, organ transplantation, [[Human Immunodeficiency Virus|Human immunodeficiency virus]] ([[Human Immunodeficiency Virus (HIV)|HIV]]) / [[acquired immunodeficiency syndrome]] ([[AIDS]]),  
*Water [[aspiration]] as in a case of [[Pseudallescheria boydii|Pseudallescheria boydii]]
**Water [[aspiration]] as in a case of Pseudoallescheria boydii
*Traumatic inoculation as in a case of [[Sporothrix schenckii]]''
**Traumatic inoculation as in a case of[[Sporothrix schenckii]]''


==Symptoms==
==Symptoms==
===Subacute Meningitis===
===[[Acute (medicine)|Acute]]/[[subacute]] Meningitis===
Symptoms of [[acute]]/[[subacute]] fungal meningitis include:
*[[Headache]]
*[[Headache]]
*[[Neck stiffness]]
*[[Neck stiffness]]
*Low grade [[fever]]
*[[fever|Low grade fever]]
*[[Fatigue]]
*[[Fatigue]]
*[[Night sweats]]
*[[Night sweats]]
*Possible [[cranial nerves]] involvement<ref>Roos KL, Tyler KL. Chapter 381. Meningitis, Encephalitis, Brain Abscess, and Empyema. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J,  eds. Harrison's Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2012.</ref>
*Possible [[cranial nerves]] involvement<ref name=":0">Roos KL, Tyler KL. Chapter 381. Meningitis, Encephalitis, Brain Abscess, and Empyema. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J,  eds. Harrison's Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2012.</ref>


===Chronic Meningitis===
===[[Chronic (medical)|Chronic]] Meningitis===
Chronic fungal meningitis may present with the following:
*[[Headache]]
*[[Headache]]
*[[Neck stiffness]]
*[[Neck stiffness]]
*[[Hydrocephalus]]
*[[Hydrocephalus]]
*[[Cranial neuropathy]]
*[[Cranial nerve disorders|Cranial neuropathy]]
*[[Radiculopathy]]
*[[Radiculopathy]]
*Cognitive and personality changes<ref>Koroshetz WJ. Chapter 382. Chronic and Recurrent Meningitis. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J,  eds. Harrison's Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2012.</ref>
*Cognitive and personality changes<ref>Koroshetz WJ. Chapter 382. Chronic and Recurrent Meningitis. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J,  eds. Harrison's Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2012.</ref>
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[[Category:Neurology]]
[[Category:Neurology]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Emergency mdicine]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]

Latest revision as of 21:47, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby; Prince Tano Djan, BSc, MBChB [2]

Overview

Fungal meningitis can occur in two main clinical pictures: subacute meningitis and chronic meningitis. Chronic meningitis is characterized by the presence of symptoms for more than four weeks. Commonly, patients with fungal meningitis have a history of one or more of the following chronic sinusitis, granulocytopenia, chronic renal failure, diabetes, pregnancy, IV drug abuse, prolonged intravenous therapy, exposure history example travel to or residence inendemic regions of the pathogen, immune suppression examples systemic neoplasia, organ transplantation, Human immunodeficiency virus (HIV) / acquired immunodeficiency syndrome (AIDS), water aspiration as in a case of Pseudoallescheria boydii and traumatic inoculation as in a case of Sporothrix schenckii. On presentation patients may have the following symptoms, headache, neck stiffness, fever, fatigue, night sweats, cranial nerves involvement,[1] hydrocephalus, cranial neuropathy, radiculopathy and cognitive and personality changes.[1]

History

Commonly, patients with fungal meningitis have a history of one or more of the following:[2][3][4][5][6][7][8][9][10][11][12]

Symptoms

Acute/subacute Meningitis

Symptoms of acute/subacute fungal meningitis include:

Chronic Meningitis

Chronic fungal meningitis may present with the following:

References

  1. ↑ 1.0 1.1 1.2 Roos KL, Tyler KL. Chapter 381. Meningitis, Encephalitis, Brain Abscess, and Empyema. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, eds. Harrison's Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2012.
  2. ↑ Morgand M, Rammaert B, Poirée S, Bougnoux ME, Tran H, Kania R; et al. (2015). "Chronic Invasive Aspergillus Sinusitis and Otitis with Meningeal Extension Successfully Treated with Voriconazole". Antimicrob Agents Chemother. 59 (12): 7857–61. doi:10.1128/AAC.01506-15. PMC 4649149. PMID 26392507.
  3. ↑ Shankar SK, Mahadevan A, Sundaram C, Sarkar C, Chacko G, Lanjewar DN; et al. (2007). "Pathobiology of fungal infections of the central nervous system with special reference to the Indian scenario". Neurol India. 55 (3): 198–215. PMID 17921648.
  4. ↑ Chiller TM, Galgiani JN, Stevens DA (2003). "Coccidioidomycosis". Infect Dis Clin North Am. 17 (1): 41–57, viii. PMID 12751260.
  5. ↑ Singh N, Husain S (2000). "Infections of the central nervous system in transplant recipients". Transpl Infect Dis. 2 (3): 101–11. PMID 11429020.
  6. ↑ Rosenstein NE, Emery KW, Werner SB, Kao A, Johnson R, Rogers D; et al. (2001). "Risk factors for severe pulmonary and disseminated coccidioidomycosis: Kern County, California, 1995-1996". Clin Infect Dis. 32 (5): 708–15. doi:10.1086/319203. PMID 11229838.
  7. ↑ Gottfredsson M, Perfect JR (2000). "Fungal meningitis". Semin Neurol. 20 (3): 307–22. doi:10.1055/s-2000-9394. PMID 11051295.
  8. ↑ Fraser DW, Ward JI, Ajello L, Plikaytis BD (1979). "Aspergillosis and other systemic mycoses. The growing problem". JAMA. 242 (15): 1631–5. PMID 480580.
  9. ↑ Perfect JR, Lang SD, Durack DT (1980). "Chronic cryptococcal meningitis: a new experimental model in rabbits". Am J Pathol. 101 (1): 177–94. PMC 1903580. PMID 7004196.
  10. ↑ Perfect JR, Durack DT (1985). "Chemotactic activity of cerebrospinal fluid in experimental cryptococcal meningitis". Sabouraudia. 23 (1): 37–45. PMID 3992427.
  11. ↑ Perfect JR, Durack DT (1985). "Effects of cyclosporine in experimental cryptococcal meningitis". Infect Immun. 50 (1): 22–6. PMC 262129. PMID 3899932.
  12. ↑ Mody CH, Toews GB, Lipscomb MF (1988). "Cyclosporin A inhibits the growth of Cryptococcus neoformans in a murine model". Infect Immun. 56 (1): 7–12. PMC 259224. PMID 3275587.
  13. ↑ Koroshetz WJ. Chapter 382. Chronic and Recurrent Meningitis. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, eds. Harrison's Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2012.

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