Skip to Main Content

We have a new app!

Take the Access library with you wherever you go—easy access to books, videos, images, podcasts, personalized features, and more.

Download the Access App here: iOS and Android

  • Meningitis

  • 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

Essentials of Diagnosis

  • 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

General Considerations

  • 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

Signs and Symptoms

  • Symptoms emerge over a few days
  • Hallucinations
  • Nausea
  • Sensitivity to light
  • Headache, stiff neck
  • Change in mental status (confusion, delirium)
  • Fever or hypothermia
  • Increased heart rate
  • Malaise

Functional Implications

  • 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

Differential Diagnosis

  • Extrapyramidal rigidity
  • Hydrocephalus
  • Alcohol intoxication or withdrawal
  • Hepatic encephalopathy
  • Subarachnoid hemorrhage
  • Meningoencephalitis
  • Epstein-Barr virus
  • Behçet’s disease

Laboratory Tests

  • 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

Diagnostic Procedures

  • 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 ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.