Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Meningitis ++ 321.0 Cryptococcal meningitis ++ B45.1 Cerebral cryptococcosis ++ 5A: Primary prevention/risk reduction for loss of balance and falling5C: Impaired motor function and sensory integrity associated with nonprogressive disorders of the central nervous system—congenital origin or acquired in infancy or childhood5D: Impaired motor function and sensory integrity associated with nonprogressive disorders of the central nervous system—acquired in adolescence or adulthood5I: Impaired arousal, range of motion, and motor control associated with coma, near coma, or vegetative state +++ Description ++ Fungal infection of the meninges of the brain and spinal cordFungus 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 natureDifferent than bacterial meningitis as symptoms emerge over a few daysNo physical test distinguishes a bacterial from a viral infection; must rely on body fluid culturesCommonly 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 +++ Demographics ++ Individuals with weak immune systems +++ Signs and Symptoms ++ Symptoms emerge over a few daysHallucinationsNauseaSensitivity to lightHeadache, stiff neckChange in mental status (confusion, delirium)Fever or hypothermiaIncreased heart rateMalaise +++ Functional Implications ++ Loss of mobility temporarily with permanent loss possibleLoss of hearing/vestibular function in some casesTemporary loss of coordination (fine and gross motor) with permanent loss possibleLoss of independence with activities of daily livingReduced cognitive function, particularly executive functions +++ Possible Contributing Causes ++ Contact with fungus Cryptococcus neoformans in the soilSevere sinus infectionCranial or spinal surgeryShunt placementOpen head injury +++ Differential Diagnosis ++ Extrapyramidal rigidityHydrocephalusAlcohol intoxication or withdrawalHepatic encephalopathySubarachnoid hemorrhageMeningoencephalitisEpstein-Barr virusBehçet’s disease +++ Laboratory Tests ++ Cryptococcal antigen in CSF or bloodLab tests for complete blood countGeneral chemistry panel and culture are used to determine the microorganism involved and the extent of the infection +++ Imaging ++ Computed tomography (CT) scan for detailed imagingMRI with gadolinium enhancementElectroencephalogram (EEG) may be helpful for patients with seizure due to infectionChest 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 microorganismsHigh polymorphonuclear leukocytes, high protein, low ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.