Fungal meningitis is a rare type of meningitis. It happens when a fungal infection elsewhere in the body spreads to the brain and spinal cord. It primarily affects people with weakened immune systems.

Meningitis is a serious condition in which the protective lining surrounding the brain and spinal cord, known as the meninges, becomes swollen. This swelling can happen if germs enter the body and infect the fluid around the brain and spinal cord.

In this article, we look at the symptoms, causes, diagnosis, and treatment of fungal meningitis.

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Fungal meningitis can cause a range of symptoms, including:

  • stiff neck
  • headaches
  • fever
  • nausea
  • vomiting
  • increased sensitivity to light
  • altered mental state, such as confusion
  • hallucinations

The symptoms may not appear as suddenly as they do in other types of meningitis, such as bacterial meningitis. Instead, they tend to come on gradually.

Fungal meningitis occurs when a fungal infection in part of the body spreads to the brain or spinal cord. Different types of fungi can cause fungal meningitis.

Cryptococcus neoformans

The Meningitis Research Foundation, a charity in the United Kingdom, notes that C. neoformans is the most common cause of fungal meningitis. C. neoformans is present in the environment, including in the soil, throughout the world.

This fungus usually only causes meningitis in people who have a weakened immune system or an underlying health condition, such as:

Learn more about cryptococcal meningitis here.


The Histoplasma fungus is common, especially in soil with high levels of bat or bird droppings. It is harmless in people who have a fully functioning immune system but can cause fungal meningitis in people with a weakened immune system.

In the United States, Histoplasma primarily lives in the central and eastern states.


Blastomyces is a fungus that lives in damp soil, decaying wood, and leaves. The fungus mostly occurs in the midwestern, south-central, and southeastern states of the U.S.


The Coccidioides fungus is present in soils in southwestern parts of the U.S. and in south-central Washington state. It also lives in Central and South America and areas of Mexico.

People may sometimes refer to a Coccidioides infection as valley fever.


Candida is a fungus that lives on the skin and inside the body. Although it usually causes no health problems, Candida can lead to meningitis in people who are at risk of this fungus infecting the bloodstream or internal organs. These people include preterm babies and those who:

  • have spent an extended period in intensive care
  • have a central venous catheter
  • have a weakened immune system
  • have had recent surgery, particularly abdominal procedures
  • have received high levels of antibiotics in the hospital
  • receive intravenous nutrition
  • have kidney failure
  • have diabetes

Risk factors

Fungal meningitis is not contagious, and people can only get it from a fungal infection. Although anyone can get fungal meningitis, certain risk factors make it more likely. These risk factors include:

  • having a weakened immune system because of surgery or a health condition, such as HIV or cancer
  • taking medications that weaken the immune system, including steroids, anti-tumor necrosis factor drugs, or medicines that people take after an organ transplant
  • being born prematurely with a very low birth weight
  • living in certain parts of the world with higher levels of fungi, such as some areas of the U.S, as this can increase the risk of fungal lung infections that could lead to meningitis

A doctor may diagnose fungal meningitis by carrying out different tests. In some cases, they may take a sample of blood or cerebrospinal fluid, which is the fluid that surrounds the spinal cord, for laboratory testing.

Testing can also tell doctors which fungus is causing the infection. This information is important in making sure that a person receives the right treatment.

Doctors will use high dosages of antifungal medication to treat fungal meningitis. People will usually need a long course of antifungal medication. They may initially receive medication intravenously before taking oral medication.

The type of antifungal medication can depend on the type of fungus and the severity of the infection.

To treat a Cryptococcus infection, doctors may use any of the following antifungal medications:

For a Histoplasma infection, doctors may prescribe an antifungal medication called itraconazole (Sporanox). People may need to take this medication for 3–12 months, depending on their immune system and the severity of the fungal infection.

Doctors may also use itraconazole to treat a mild or moderate Blastomyces infection. For more severe infections, people may need amphotericin B. People with a Blastomyces infection may need treatment for 6–12 months.

If Coccidioides fungus is responsible for the condition, people may need lifelong treatment with antifungal medication. Doctors may use fluconazole or another type of antifungal medication.

To treat a Candida infection, doctors prescribe a class of antifungal drugs called echinocandins, which they deliver intravenously.

The amount of time that it takes to treat fungal meningitis can vary depending on the individual and the type of fungus causing the condition.

People with a weakened immune system may need to undergo treatment for a longer period of time.

Some people may require maintenance therapy. This means they will continue taking antifungal medication in the long term and possibly indefinitely.

Most people will recover from fungal meningitis with no permanent effects. However, recovery is different for each individual. It can take time, and a person may feel tired or low in energy as they recover.

In some people, meningitis can cause temporary or permanent effects. According to the Meningitis Research Foundation, the health issues meningitis can cause include:

  • memory loss or difficulty concentrating
  • difficulties with coordination
  • headaches
  • hearing issues
  • loss of balance
  • seizures
  • weakness or spasms
  • speech problems
  • vision problems

A person can work with a doctor to create a treatment plan. They may also find support networks helpful in connecting them with others who have experienced fungal meningitis.

Fungal meningitis is a rare type of meningitis that usually only affects people with a weakened immune system.

People will need to take antifungal medication to treat fungal meningitis. In some cases, they may need lifelong treatment to manage the condition. Most people recover without experiencing any long-term effects, though.