Fungal meningitis risk factors

Fungal meningitis rarely occurs in otherwise healthy individuals. Co-existing medical conditions, immunosuppression and travel history to areas where specific fungi are endemic are risk factors for fungal meningitis. ^{[1][2][3][4][5][6][7][8]}

Risk factors in the development of fungal meningitis include:^{[9][10][1][2][3][4][5][6][7][8][11]}

• Aspergillus sp.
  • Sinusitis
  • Granulocytopenia
  • Immunosuppression
  • Chronic renal failure
  • Diabetes
• Blastomyces dermatitidis
  • Travel to or residence in midwestern and southeastern USA
  • Systemic infection
  • Abscesses
  • Draining sinus
  • Ulcers
• Coccidioides immitis
  • Exposure history
  • Travel to or residence in southwestern United States
  • Dark-skinned races
  • Elderly individuals
  • Income of < $15,000 per year
  • Pregnancy
  • Persons with diabetes and
  • Smoking
• Candida sp.
  • IV drug abuse
  • Post surgery
  • Prolonged intravenous therapy
  • Disseminated candidiasis
• Cryptococcus neoformans
  • Human immunodeficiency virus (HIV) / acquired immunodeficiency syndrome (AIDS)
  • Immune suppression (examples systemic neoplasia and organ transplantation)
  • Pigeon exposure
  • Skin and other organ involvement due to disseminated infection
• Histoplasma capsulatum
  • Exposure history
  • Travel to or residence in Ohio and central Mississippi River Valley
  • Human immunodeficiency virus (HIV) / acquired immunodeficiency syndrome (AIDS)
  • Mucosal lesions
• Pseudallescheria boydii
  • Water aspiration
• Sporothrix schenckii
  • Traumatic inoculation
  • IV drug use
  • Ulcerated skin lesion^[12]

Children with the following conditions have higher incidence of fungal meningitis:

• Myeloperoxidase deficiency^[13][14]

• Chronic granulomatous disease of childhood^[15][16]

• Chronic mucocutaneous candidiasis^[17]

• White blood cell defects^[15][16]

• Severe combined immunodeficiency SCID^[18]

• Advanced HIV^[19]

• Direct extension via trauma ^[20]

• Post ventriculostomy placement, or ventricular shunts, especially after antibacterial therapy^[21][22]

• Use of bischloroethylnitrosourea polymer wafers implanted for local therapy of CNS malignancies^[23][24]

• CNS drains and catheters represent disease^[25]

• In premature infants and neonates^[26]

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