Cryptococcal Meningitis

Key facts

• Cryptococcal meningitis is a potentially life-threatening infection of the membranes surrounding the brain and spinal cord, caused by the fungus Cryptococcus neoformans, found in soil and bird droppings worldwide.
• Most people with healthy immune systems clear the fungus without symptoms; serious disease is far more common in people whose immunity is compromised, particularly those living with HIV.
• Treatment runs in phases: an induction phase of high-dose antifungal medicine, followed by consolidation and maintenance. Fluconazole, an antifungal, is the mainstay of the later stages, and the full course runs for months.
• Headache, fever, neck stiffness, sensitivity to light, and confusion are warning signs that need urgent medical assessment.

What causes it

Cryptococcal meningitis is caused by the fungus Cryptococcus neoformans, found in soil and bird droppings worldwide. Most people with healthy immune systems clear the fungus without symptoms. Serious disease is far more common in people whose immunity is compromised, particularly those living with HIV; patients who are not on antiretroviral therapy, or who present late, face the highest risk of severe disease.

How antifungal treatment works

Treatment typically proceeds in phases: an induction phase using high-dose antifungal medicine to clear the infection, followed by a consolidation and then a maintenance phase to prevent relapse. Fluconazole is a cornerstone of the consolidation and maintenance stages and belongs to the antifungals class of medicines. The full course runs for months; stopping early substantially raises the risk of the infection returning.

When to see a doctor

Headache, fever, neck stiffness, sensitivity to light, and confusion are warning signs that need urgent medical assessment. Do not wait these out. Anyone with a weakened immune system, especially those living with HIV who are not yet on treatment, should have new headaches or fever checked without delay, since early diagnosis makes the difference between a manageable infection and a life-threatening one.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.