Cryptococcal meningitis

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By Joseph R Berger MD

Cryptococcal meningitis is also known as or subsumes Cryptococcoma and Cryptococcal meningoencephalitis. -ed.

Cryptococcal meningitis is the most common form of meningitis observed in AIDS, affecting 1% to 10% of HIV-infected persons. Other immunosuppressive conditions also predispose to its development, such as corticosteroid administration; however, it may also be seen in immunologically normal persons. Cryptococcal meningitis may be difficult to diagnose as its clinical features are often subtle. Headache is the most common of symptoms, but it is not universally present and papilledema occurs in less than one third of persons. On occasion, cryptococcal infection of the CNS presents as mass lesion in the brain (cyst, granuloma, or abscess) or as encephalitis. The toxicity of the antifungal drugs, particularly, amphotericin may render treatment difficult. In the AIDS population, long term prophylaxis may be required.