Most often, this disease develops in those people who suffer from a weakened immune system. And also those patients who have a history of a neoplasm belonging to the class of malignant, people suffering from diabetes mellitus, hemoblastosis, AIDS and uremia.
Meningitis itself is an infection that affects the soft and hard membrane of the human brain. The clinical picture of this disease is demonstrated by chronic fever, increased drowsiness, frequent headaches, and weakness. We will talk about the causes and symptoms of cryptococcal meningitis in HIV-infected and healthy people below.
Common causes of this disease
In order for this disease to begin to develop in the human body, it is necessary to create optimal conditions for the pathogenic fungus. When it enters the patient’s blood, and this can happen by airborne droplets, he immediately becomes a source of infection for the environment. The most common pathogens and causes of cryptococcal meningitis, the photo of which is not laid out for ethical reasons, are:
- Cryptococci. These pathogens are the most common. They enter the environment from bird droppings, such fungi can be found in fresh fruits and vegetables, many streptococci are stored in the soil. And you can easily get infected with this fungus during a meal or inhalation of dust particles. The bulk of cases in this way relate to people who are sick with AIDS. Among them, cases of infection are much more common.
- Candidates. This type of fungal disease is natural, it lives in the human body, but is in a sleeping state. If it is activated, then the development of infectious diseases will begin, often this occurs against the background of immunodeficiency. Cases of meningitis from Candida cause 15% of the total number of patients.
- Coccidia. In order for this virus to become the causative agent of meningitis, you must live in endemic regions of the United States or in Central America.
These viral diseases primarily affect the brain. This occurs against the background of other infections, most often the disease affects elderly patients who have a deficiency of immunity, and pregnant women. Unfortunately, those at risk are those who experience immunodeficiency. Cryptococcal meningitis affects HIV-infected, patients with diabetes mellitus, people with alcoholism, newborns, patients who underwent cytostatic therapy. Cancer patients, patients with chronic renal failure and people who have blood diseases are also at risk.
Infection mechanism
When a virus enters the human body, it becomes a pathogen and protective immunological factors begin to respond to it. They have the function of preventing the further development of the infection, provided that the patient is physically healthy.
If a person has weakened immunity, fungal diseases will begin to develop in the body without any problems. Against the backdrop of this ailment, immunity will begin to decrease gradually, as it will try to resist fungal spores, but at the same time, the blood flow will carry them throughout the body, provoking the development of cryptococcal meningitis in various organs and tissues. In these places, the pathogen will actively develop. At the moment when the spore enters the membrane of the brain, the fungus will have to face a real barrier, since the brain tissue provides complete protection against penetration.
How is it going?
Cryptococcal meningitis during its active formation is accompanied by serious inflammation. In the process of the development of the disease, turbidity and thickening of the tissue membrane occurs, its surface acquires a slightly tuberous character. In rare cases, the patient has a pathology in the form of hemorrhage. The inflammatory process is actively spreading and at any moment it can begin to attack the cerebral substance, and thus encephalitis begins to develop in the lining of the spinal cord.
Disease classification
In neurology, several definitions of this lesion are used, they are classified depending on the etiology and on the clinical course. From what pathogen struck the human body, meningitis can be cryptococcal and candidal or aspergillosis, as well as histoplasmic. Depending on the course of the disease, meningitis is divided into:
Chronic implies symptoms for several weeks, with regard to clinical manifestations, this occurs at a moderate pace. If you consider the subacute option, it differs from the acute one in that the symptoms are slowly implemented and it is slightly blurred. Subsequently, such meningitis can turn into chronic.
Acute meningitis appears suddenly, it develops rapidly, and the symptomatology shows itself “in all its glory”. This type of meningitis is extremely rare, and it is mainly of the candidal type.
Symptoms of the disease
The onset of the disease often has characteristic indicators, they demonstrate symptoms very slowly, so it is not immediately possible to determine the exact diagnosis. But the patient has headaches, fever, vomiting and drowsiness.
Vomiting can be repeated, and each time the state of health will become worse. The patient’s body temperature will be between 37.2 and 37.9. Also, one of the symptoms of cryptococcal meningitis is that the patient has an appetite, a complete aversion to food, a state of sluggish, constantly want to sleep, fatigue occurs very quickly, reaction seems inhibited. Often patients have a sensitivity to light, anxiety appears.
Diagnosis of Meningitis
It is extremely difficult to diagnose such a disease, since the symptoms are very blurry, there are no clear signs of a meningeal syndrome, and this, in turn, makes it difficult to make a correct diagnosis. In order to find out what is with the patient, it is necessary to conduct the following studies:
- Neurologist examination. The doctor will monitor the patient, find out if there are any meningeal symptoms, assess the level of consciousness, and also find out if there are signs that would indicate damage to the spinal cord.
- Lumbar puncture is performed. This procedure allows you to find out the liquid pressure, also understand the degree of transparency of the cerebrospinal fluid and evaluate its color. After this, the fluid is sent for microscopy, where in the case of a disease, fungal spores are found.
- MRI of the head. This procedure is performed in order to avoid cerebral expression.
Analyzes are sent to the laboratory in order to verify the pathogens, to find out its sensitivity to antimycotic drugs.
After identifying the symptoms of cryptococcal meningitis, treatment should be prescribed immediately.
Therapy
Basically, the treatment of this disease is carried out with the help of drugs. Until the data on the determination of the fungus are confirmed, treatment is carried out empirically. After that, according to the results of the tests, a certain therapy is established.
A course of treatment
Without consulting a specialist, therapy should not be carried out in any case. The course of treatment is determined by the doctor and has three directions:
- Monotherapy. It is carried out with the help of slow drip administration of the drug to the patient. If there are indicators requiring a more intensive administration of the drug, then therapy may take from 1.5 to 2.5 months. This treatment lasts until the moment, until the complete rehabilitation of the cerebrospinal fluid.
- Combined treatment. This type of procedure involves a combination of several drugs intended for complex therapy. This method is considered the most effective in patients with streptococcal infection. The combination of drugs is prescribed individually, at the moment no specific set has been established.
- Anti-relapse therapy. This event is necessary as a preventive measure so that the disease does not have a relapse. As the main treatment is performed, the treatment of symptomatology is also carried out. Doctors are committed to stopping vomiting, normalizing internal pressure, and fighting convulsive syndrome, which often occurs in patients with meningitis.
Complications
In 40 out of 100 patients, meningitis occurs with impaired functioning of the internal organs. This leads to nausea and frequent urge to vomit. This infectious process begins to develop and penetrates the membrane of the spinal cord or brain, and thus radicular syndrome appears.
If the disease was transferred to an infectious-inflammatory level, then in this case, the cerebral tissues begin to acquire new symptoms, a serious impairment of consciousness occurs. This fungal disease is very dangerous, as it can affect the brain, and this will lead to a coma or death.