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Fungal Pathogen |
Disease |
Risk Factors |
Symptoms |
Cryptococcus neoformans |
Cryptococcal meningitis |
Common in immunocompromised individuals, especially those with HIV/AIDS |
Headache, fever, neck stiffness, altered mental status, photophobia, and nausea |
Aspergillus species |
Aspergillosis (brain abscess, meningitis) |
Common in patients with prolonged neutropenia, hematologic malignancies, or organ transplantation |
Focal neurological deficits, seizures, altered consciousness, and fever |
Candida species |
Candidiasis (meningitis, brain abscess, encephalitis) |
Common in critically ill patients, those with indwelling catheters, or those receiving broad-spectrum antibiotics |
Fever, headache, seizures, and altered mental status |
Coccidioides immitis |
Coccidioidomycosis (Valley Fever, meningitis) |
Endemic to the Southwestern United States, especially in immunocompromised individuals |
Headache, fever, neck stiffness, and neurologic deficits |
Histoplasma capsulatum |
Histoplasmosis (chronic meningitis) |
Exposure to bird or bat droppings, especially in immunocompromised patients |
Fever, headache, confusion, and neck stiffness |
Mucorales species |
Mucormycosis (rhinocerebral, meningitis) |
Common in patients with uncontrolled diabetes, organ transplants, or those on long-term corticosteroids |
Facial pain, headache, cranial nerve deficits, and altered mental status |
Fungal Pathogen |
First-Line Treatment |
Alternative/Adjunctive Treatment |
Comments |
Cryptococcus neoformans |
Amphotericin B + Flucytosine |
Fluconazole (for maintenance therapy) |
Initial induction therapy followed by long-term maintenance with fluconazole to prevent relapse, especially in HIV patients. |
Aspergillus species |
Voriconazole |
Liposomal Amphotericin B, Isavuconazole |
Voriconazole is the preferred treatment; surgical intervention may be required for abscesses. |
Candida species |
Liposomal Amphotericin B |
Fluconazole, Caspofungin |
Liposomal Amphotericin B is preferred for CNS involvement; Fluconazole may be used for step-down therapy. |
Coccidioides immitis |
Fluconazole or Itraconazole |
Liposomal Amphotericin B (for severe cases) |
Long-term therapy is often required; treatment may need to be lifelong in some cases. |
Histoplasma capsulatum |
Liposomal Amphotericin B |
Itraconazole (for maintenance therapy) |
Induction with Amphotericin B followed by maintenance with itraconazole for an extended period. |
Mucorales species |
Liposomal Amphotericin B |
Posaconazole, Isavuconazole |
Early and aggressive surgical debridement is often necessary in addition to antifungal therapy. |