Fungal Meningitis

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Organism, Causative Agent, or Etiologic Agent
Fungal meningitis is caused by different types of fungi such as Cryptococcus, Candida, Histoplasma, and Coccidioides.

Fungal meningitis is usually acquired by inhaling fungal spores from the environment. Fungal meningitis is not contagious and is not transmitted from person to person.

Symptoms (including complications and population-at-risk)
Symptoms of fungal meningitis are similar to symptoms of other forms of meningitis, like headache, fever, nausea, and stiffness of the neck however they often appear more gradually. Also those with fungal meningitis may also experience, dislike of bright lights, changes in mental status, confusion, hallucinations, and personality changes. 

Those at high risk for fungal meningitis include those who have certain medical conditions like diabetes, cancer, HIV, AIDS, leukemia, or an immune system that does not respond adequately to infections and an immune system malfunction as a result of medical treatment. 

Avoiding exposure to environments likely to contain fungal elements can assist with preventing fungal meningitis. People who are immunosuppressed (for example, those with HIV infection) should try to avoid bird droppings and avoid digging and dusting activities, particularly if they live in a geographic region where fungi like Histoplasma, Coccidioides, or Blastomyces species exist. Some guidelines recommend that HIV-infected people receive antifungal prophylaxis if they live in a geographic area where the incidence of fungal infections is very high.

School Exclusion Criteria
Children with fungal meningitis should be kept out of school or childcare until they are fever free for 24 hours without the use of fever suppressing medications.   Rules for exclusion of sick children from school and childcare are outlined in the Texas Administrative Code, specifically Rule 97.7 for schools and Rule 746.3603 for childcare. 

Recent Texas Trends
For the year 2012, fungal meningitis only accounted for 4.5% of all meningitis reports received by the Emerging and Acute Infectious Disease Branch of the Texas Department of State Health Services. Fungal meningitis was last reportable in Texas in 2012.
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