Fungal Meningitis

Question 1

How often does fungal meningitis occur?

Answer 1

Rarely –> opportunistic

Question 2

How does fungal meningitis spread?

Answer 2

Bloodstream to CNS

Question 3

Are infections that cause fungal meningitis contagious?

Answer 3

NOPE

Question 4

Dx of fungal meningitis is through?

Answer 4

Lumbar Puncture

Question 5

What look at from the sample CSF?

Answer 5

Microscopic exam
Culture –> slow
Antigen detection
PCR

Question 6

Most common fungal cause of meningitis?

Answer 6

Cryptococcus neoformans

Question 7

What populations is the majority of cryptococcus neoformans meningitis seen in?

Answer 7

HIV-infected pts [85%] (immunocompromised)

Question 8

Where is Cryptococcus neoformans found?

Answer 8

Pigeon droppings

Question 9

How is Cryptococcus neoformans transferred?

Answer 9

Inhalation

Question 10

Is Cryptococcus neoformans dimorphic? If not, what is its form?

Answer 10

Nope
Encapsulated yeast (always)

Question 11

What are the initial symptoms of a Cryptococcal infection?

Answer 11

None they are asymptomatic

Question 12

Where does the initial infection occur with cryptococcus?

Answer 12

Pulmonary infection

Question 13

What stain do you on CSF with a suspected cryptococcal infection?

Answer 13

India Ink

Question 14

What do you look for on an India ink stain of CSF when suspecting a cryptococcal infection? What causes these?

Answer 14

Halos

Polysaccharide capsule that excludes the India ink

Question 15

What is the most effective test for cryptococcus?

Answer 15

Antigen detection for polysaccharide capsule

Question 16

Tx of cryptococcus?

Answer 16

Amp B

Flucytosine –> crosses BBB better than Amp B

Question 17

Major cause of steroid-associated meningitis?

Answer 17

Exserohilum rostratum

Question 18

Diagnosis of Exserohilum rostratum?

Answer 18

Culture

PCR (CDC only)