Epidemiology of Cryptococcal Meningitis

        Meninges are the membranes that surround the brain and the spinal cord. Meningitis can be defined as infection to the meninges caused due to bacteria, viruses, fungi or other parasites resulting in an inflammation of the membranes.

     Cryptococcal meningitis is an infection of the brain primarily caused by a fungus called Cryptococcus neoformans. Cryptococcal neoformans is a budding, encapsulated, solid yeast found ubiquitously in the soil and bird droppings. The route of infection of this fungus is through respiratory tract. Even though humans do get exposed to Cryptococcus, infections do not occur as the infectious agent is removed though cell-mediated immunity that exists in the human body. As per epidemiological studies, occurrence of Cryptococcus meningitis is very rare in case of healthy individuals. However, Cryptococcus meningitis is the most common, opportunistic and fatal fungal infection that occurs primarily in individuals who are immuno-compromised and those who are suffering with acquired immunodeficiency syndrome or AIDS. Around 20 percent of all AIDS-related deaths occur due to Cryptococcus meningitis, making it the second most common cause of death in HIV infection after tuberculosis.

     Prevalence of this disease in a set of population is an indicative of immune suppression in that group. Experts consider Cryptococcus meningitis as a sentinel marker along with pneumonia and sepsis that suggest the spread of HIV pandemic in a particular region. Primarily, Asian hospitals have witnessed a significant raise in the number of patients suffering with Cryptococcus meningitis in the recent years, thus indicating a wide spread HIV infection within the Asian community.

      Apart from HIV, other important medical conditions where Cryptococcus meningitis can occur include immunosuppression during organ transplants, sarcoidosis, lymphoproliferative disorder, hypogammaglobulinaemia, corticosteroid therapy, SLE, cirrhosis and peritoneal dialysis.

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