Fungal meningitis risk factors

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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]


Fungal meningitis rarely occurs in otherwise healthy individuals. Co-existing medical conditions, immunosuppression and travel history to areas where specific fungi are endemic are risk factors for fungal meningitis. [1][2][3][4][5][6][7][8]

Risk Factors

Risk factors in the development of fungal meningitis include:[9][10][1][2][3][4][5][6][7][8][11]

Risk factors by the causative organism

Risk factors in children

Children with the following conditions have higher incidence of fungal meningitis:

  • CNS drains and catheters represent disease[25]


  1. 1.0 1.1 Chiller TM, Galgiani JN, Stevens DA (2003). "Coccidioidomycosis". Infect Dis Clin North Am. 17 (1): 41–57, viii. PMID 12751260.
  2. 2.0 2.1 Singh N, Husain S (2000). "Infections of the central nervous system in transplant recipients". Transpl Infect Dis. 2 (3): 101–11. PMID 11429020.
  3. 3.0 3.1 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.
  4. 4.0 4.1 Gottfredsson M, Perfect JR (2000). "Fungal meningitis". Semin Neurol. 20 (3): 307–22. doi:10.1055/s-2000-9394. PMID 11051295.
  5. 5.0 5.1 Fraser DW, Ward JI, Ajello L, Plikaytis BD (1979). "Aspergillosis and other systemic mycoses. The growing problem". JAMA. 242 (15): 1631–5. PMID 480580.
  6. 6.0 6.1 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.
  7. 7.0 7.1 Perfect JR, Durack DT (1985). "Chemotactic activity of cerebrospinal fluid in experimental cryptococcal meningitis". Sabouraudia. 23 (1): 37–45. PMID 3992427.
  8. 8.0 8.1 Perfect JR, Durack DT (1985). "Effects of cyclosporine in experimental cryptococcal meningitis". Infect Immun. 50 (1): 22–6. PMC 262129. PMID 3899932.
  9. 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.
  10. 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.
  11. 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.
  12. 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.
  13. Oleske J, Minnefor A, Cooper R, Thomas K, dela Cruz A, Ahdieh H; et al. (1983). "Immune deficiency syndrome in children". JAMA. 249 (17): 2345–9. PMID 6834633.
  14. Ludviksson BR, Thorarensen O, Gudnason T, Halldorsson S (1993). "Candida albicans meningitis in a child with myeloperoxidase deficiency". Pediatr Infect Dis J. 12 (2): 162–4. PMID 8381226.
  15. 15.0 15.1 Cohen MS, Isturiz RE, Malech HL, Root RK, Wilfert CM, Gutman L; et al. (1981). "Fungal infection in chronic granulomatous disease. The importance of the phagocyte in defense against fungi". Am J Med. 71 (1): 59–66. PMID 7195647.
  16. 16.0 16.1 Fleischmann J, Church JA, Lehrer RI (1986). "Primary Candida meningitis and chronic granulomatous disease". Am J Med Sci. 291 (5): 334–41. PMID 3706396.
  17. Germain M, Gourdeau M, Hébert J (1994). "Case report: familial chronic mucocutaneous candidiasis complicated by deep candida infection". Am J Med Sci. 307 (4): 282–3. PMID 8160723.
  18. Smego RA, Devoe PW, Sampson HA, Perfect JR, Wilfert CM, Buckley RH (1984). "Candida meningitis in two children with severe combined immunodeficiency". J Pediatr. 104 (6): 902–4. PMID 6726524.
  19. Casado JL, Quereda C, Oliva J, Navas E, Moreno A, Pintado V; et al. (1997). "Candidal meningitis in HIV-infected patients: analysis of 14 cases". Clin Infect Dis. 25 (3): 673–6. PMID 9314460.
  20. Brenier-Pinchart MP, Leclercq P, Mallié M, Bettega G (1999). "Candida meningitis possibly resulting from a harpoon injury". Eur J Clin Microbiol Infect Dis. 18 (6): 454–5. PMID 10442428.
  21. O'Brien D, Stevens NT, Lim CH, O'Brien DF, Smyth E, Fitzpatrick F; et al. (2011). "Candida infection of the central nervous system following neurosurgery: a 12-year review". Acta Neurochir (Wien). 153 (6): 1347–50. doi:10.1007/s00701-011-0990-9. PMID 21431456.
  22. Nguyen MH, Yu VL (1995). "Meningitis caused by Candida species: an emerging problem in neurosurgical patients". Clin Infect Dis. 21 (2): 323–7. PMID 8562739.
  23. O'Brien D, Cotter M, Lim CH, Sattar MT, Smyth E, Fitzpatrick F (2011). "Candida parapsilosis meningitis associated with Gliadel (BCNU) wafer implants". Br J Neurosurg. 25 (2): 289–91. doi:10.3109/02688697.2010.534202. PMID 21158511.
  24. Glick JA, Graham RS, Voils SA (2010). "Candida meningitis post Gliadel wafer placement successfully treated with intrathecal and intravenous amphotericin B." Ann Pharmacother. 44 (1): 215–8. doi:10.1345/aph.1M453. PMID 20028954.
  25. Geers TA, Gordon SM (1999). "Clinical significance of Candida species isolated from cerebrospinal fluid following neurosurgery". Clin Infect Dis. 28 (5): 1139–47. doi:10.1086/514755. PMID 10452649.
  26. Fernandez M, Moylett EH, Noyola DE, Baker CJ (2000). "Candidal meningitis in neonates: a 10-year review". Clin Infect Dis. 31 (2): 458–63. doi:10.1086/313973. PMID 10987705.

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