- 321.0 Cryptococcal meningitis
- B45.1 Cerebral cryptococcosis
- Fungal infection of the meninges of the brain and spinal cord
- Fungus Cryptococcus neoformans is found in the soil
- Severity and extent of the infection causes a wide range of neurologic signs and symptoms, generally non-focal in nature
- Different than bacterial meningitis as symptoms emerge over a few days
- No physical test distinguishes a bacterial from a viral infection; must rely on body fluid cultures
- Commonly nosocomial or iatrogenic
- If a central nervous system infection is suspected, the therapist should seek information regarding a potential source of infection or a condition that predisposed the patient to infection
- Individuals with weak immune systems
- Symptoms emerge over a few days
- Sensitivity to light
- Headache, stiff neck
- Change in mental status (confusion, delirium)
- Fever or hypothermia
- Increased heart rate
- Loss of mobility temporarily with permanent loss possible
- Loss of hearing/vestibular function in some cases
- Temporary loss of coordination (fine and gross motor) with permanent loss possible
- Loss of independence with activities of daily living
- Reduced cognitive function, particularly executive functions
Possible Contributing Causes
- Contact with fungus Cryptococcus neoformans in the soil
- Severe sinus infection
- Cranial or spinal surgery
- Shunt placement
- Open head injury
- Extrapyramidal rigidity
- Alcohol intoxication or withdrawal
- Hepatic encephalopathy
- Subarachnoid hemorrhage
- Epstein-Barr virus
- Behçet’s disease
- Cryptococcal antigen in CSF or blood
- Lab tests for complete blood count
- General chemistry panel and culture are used to determine the microorganism involved and the extent of the infection
- Computed tomography (CT) scan for detailed imaging
- MRI with gadolinium enhancement
- Electroencephalogram (EEG) may be helpful for patients with seizure due to infection
- Chest radiographs to disclose area of abscess that may be the original site of infection
- Lumbar puncture to test the cerebral spinal fluid for presence of red and white blood cells, protein concentration, glucose, and microorganisms
- High polymorphonuclear leukocytes, high protein, low glucose suggests bacterial infection
- Predominant lymphocytes, high protein, low glucose suggests ...
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