Free «Fungal Meningitis» Essay Paper

Introduction

Fungal Meningitis is a form of meningitis, which is caused by some fungal infection. It is also an inflammation of the lining, which protects and surrounds a person’s spinal cord and brain. This inflammation, which is normally caused by some fungal infection, can seriously affect an individual’s health if not carefully managed (Safdieh et al., 2008).

Those who are vulnerable to this disorder are patients with chronic diseases such as AIDS and cancer. Cases of fungal meningitis have been consistently rising on a global scale, particularly over the last decade. In the USA, for instance, the National Health Data estimates cases of fungal infections to be around 1,500 on a yearly basis. In 2014, the Center for Disease Control presented a report that 409 patients had been confirmed to be infected with fungal meningitis (Safdieh et al., 2008).

There are various types of fungus, which causes fungal meningitis. These include Candida albicans, Cryptococcus neoformans, and Histoplasma. Although there may be other causes, these are the main ones. In essence, fungal meningitis is one of the most recent and dangerous inflammations that is caused by several types of fungus. However, it can cause meningitis and other diseases in immuno-deficient patients. This paper is concerned about finding out those who are more vulnerable to this order. Other questions explored are whether it is contagious. How does it develop in human bodies? How can one know and determine what kind of fungus causes it? Finally, the paper will also find out if there is way to prevent it from developing among those people who have weak immune systems and immuno-deficient patients. These are the key points the research paper will focus. Mostly, this paper will focus on how the fungus develops in the human body and determine various kinds of fungus that causes the infection.

Causes of Fungal Meningitis

Candida Albicans                                                                                

Candida albicans is a type of fungus, which results into thrush. In some cases, it leads to a risk form of meningitis, particularly for babies who are born prematurely and those with low body weight (Meningitis Research Foundation, n.d.).

Cryptococcus Neoformans

This type of virus causes most cases of fungal meningitis. The virus is brought about by a fungus or yeast that is commonly found in the soil or the environment. In general, only individuals who have low immune systems, including those with cancer, HIV, and diabetes, are vulnerable to cryptococcal infection. Symptoms of Cryptococcal meningitis include nausea, headache, vomiting, stiff neck, fever, hallucinations, changes in mental states, and bright lights. However, unlike acute bacterial meningitis where symptoms appear suddenly, symptoms of Cryptococcus neoformans appear on a gradual basis. Cryptococcus is the major cause of fungal meningitis, particularly for people with weak immune systems. Cryptococcus has been perceived to have been obtained through inhaling soil or air, which have been polluted with bird droppings (Saag et al., 2000).

Histoplasma

Though Histoplasma fungus is common, it does not harbor serious risks, particularly for people who have immune systems that are functioning. However, they can lead to meningitis and other serious disorders, especially for patients who have low immune-deficiency systems. Histoplasma can be found in environments, which have been heavily contaminated with bat or bird droppings (Jaiswal et al., 2002).

Medications that Weaken Body’s Immune System

An individual can also obtain fungal meningitis from taking therapies or medications that weaken their immune systems. A good example of such medications includes, but is not limited to steroids such as prednisone and many others. Other such medications include anti-TNF medications, which are sometimes given to patients after organ transplants, with rheumatoid arthritis, and with other autoimmune disorders. There is also a connection of fungal meningitis outbreak with spinal steroid injections, which is a common therapy for back pain. The steroid, which is also identified as methylprednisolone acetate, is manufactured in England. The company that manufactures it, New England Compounding Center, has recalled most lots of these products and shut down its operations (Saag et al., 2000).

Symptoms

Symptoms of fungal meningitis include vomiting, headache, numbness, and sensitivity to light. Other factors that should be looked into are increasing pain, joint swellings, and redness at the injection site. If the infection goes on for a long time without serious treatment, then it may lead to unconsciousness on the part of a patient who may fall into a comma. Fungal meningitis can also have an impact on patient’s blood vessels. This may lead to bleeding and blood clothing. In addition, a patient may develop problems with maintaining stability and speaking. In some cases, these symptoms may be overlooked as side effects of stroke (Jaiswal et al., 2002). Therefore, it is important that patients whose symptoms appear as stroke-related be tested to ascertain whether the condition may be fungal meningitis.

Transmission

Contrary to a popular belief, this disorder is not transmitted through contact with another person. In other words, it is not contagious.  The disorder develops when the fungus spreads in the bloodstream from some place in a person’s body. Consequently, the fungus is introduced into the body through the central nervous system. In addition, it can also be introduced into the body from an infected body site, which is just next to the central nervous system (Meningitis Research Foundation, n.d.).

Spores can also be inhaled from the environment, from the soil, or in some cases in a health care setting. The disorder develops when the fungus spreads to an individual’s spinal cord through blood. Despite the fact that anyone is at risk of contracting fungal meningitis, those who are more at risk are patients with weak immune systems (Jaiswal et al., 2002).

Risk Factors

Risk factors for fungal meningitis include certain surgical procedures, diseases and medications that reduce strength of the body’s immune system. Additionally, these may also increase one’s risk of acquiring fungal infection, resulting into fungal meningitis. Premature babies with low birth weight are also vulnerable to Candida blood infection, which spreads to the brain (Meningitis Research Foundation, n.d.).

Those who are living in the US are at an increased risk of acquiring fungal infections. For instance, bat and bird droppings in the Western US have been found to contain traces of Histoplasma. Moreover, the majority of soil in South-Western US could contain Coccidioides. Other people who are also vulnerable are Filipinos, African Americans, and pregnant women who are about to deliver. Further, individuals with weak immune systems have a high likelihood of acquiring coccidodes infection, which is also identified as valley fever (Saag et al., 2000).

Diagnosis

It is important to understand particular causes of meningitis. This is because treatments and therapies are usually administered based on specific causes. Upon suspicion of meningitis, cerebrospinal fluid or a blood sample should be collected and tested in a laboratory. In order to confirm presence of fungal meningitis for an individual, there should be specific lab tests, which should be done based on the kind of fungus suspected (Jaiswal et al., 2002).

Furthermore, a lumbar puncture can also be done on an individual whereby cerebrospinal fluid is drawn from the spine. This procedure is also identified as spinal tap. In the process of lumbar puncture, a patient is expected to lie on his or her back. Caregivers then clean a specific area of a person’s back. A needle is inserted, which removes fluid from the patient’s spinal cord. The fluid is then taken to the lab for tests (Safdieh et al., 2008).

The fluid is inspected for signs of the disorder. Concerns relating to this test include bleeding around the spinal cord or brain, infection, and other issues. In some cases, some medicines may be put into the patient’s back in order to treat the illness. Once the disease is detected, it can be treated with doses of intravenous antifungal medications that may go on for some months (“Cryptococcosis,” n.d.).

CAT or ACT scan can be used in taking pictures of the person’s brain or skull. Prior to the scan, a patient is usually offered contrast liquid. However, there are those who are allergic to contrast liquid. Thus, any signs of allergic reaction should be reported to the responsible health care personnel who should take immediate actions.

Another form of diagnosing fungal meningitis involves using the MRI. In essence, the MRI takes pictures of patient’s skull, blood vessels, and the brain. In order to make pictures quickly, a patient is usually given contrast liquid. However, in the event the MRI is used, a patient is advised not to enter the MRI room with any metallic object. Moreover, any metal object in the body should be removed. This owes to the fact that metals could cause serious injury (“Cryptococcosis,” n.d.).

Treatment

The majority of treatments involve high doses of antifungal medication. In most cases, these medications are offered through IV line in a medical facility. Antifungal medicine assists in killing the fungus that causes the infection. Most medicines used to treat fungal meningitis may not be taken alongside with antifungal medicine. A patient should inform a caregiver if he or she is taking herbs, vitamins, other medicines, or food supplements. Other forms of medicines are fever medicine, steroids, and anti-nausea medicine. Fever medicine is used to lower the patient’s temperature. However, steroids have been found to reduce immunity like drugs that treat autoimmune conditions and rheumatoid arthritis. Nonetheless, epidural injections have no such complications and are normally regarded as safe. In general, epidural injections are considered as safe and complications are rare (Slavoski & Tunkel, 1995).

Common medicines used to lower the patient’s temperature include ibuprofen or acetaminophen. Steroids are also given to decrease inflammation. In turn, anti-nausea medicine is given for preventing vomiting, as well as calming the stomach (“Cryptococcosis,” n.d.)

The length of treatment depends on the severity of the ailment, as well as the status of the immune system. As discussed earlier, treatment also depends on the type of fungus that has led to the infection. For instance, treatment is usually longer for people with such conditions as diabetes, AIDS, cancer, and many others (Slavoski & Tunkel, 1995).

How Fungal Meningitis Affects the Body System

As a rule, the brain is naturally sheltered from the body’s immune system by a barrier that is created by meninges situated between the brain and the bloodstream. Usually, this assists in preventing the body from mounting a reaction to the immune system in attacking itself. This can become a problem in the event of meningitis. Once bacteria or any other virus force their way into the brain, they are in some way isolated from the body’s immune system and then spread to other parts of the body. However, the body begins on a gradual basis to attack the infection and this causes the problem to intensify. When the body starts fighting the infection, blood vessels may be leaky and allow the infection-fighting particles, blood cells, and fluid to penetrate the brain and meninges. As a result, the brain begins to swell, which results in a decreased blood flow to some parts of the brain. It worsens the impact of the infection on a patient (Slavoski & Tunkel, 1995).

The fungus, which causes meningitis, moves in an abnormal route all the way through the human body. It travels upwards via the spinal fluid, eventually reaching the brain. From the brain, it then travels to various parts of the body and attacks blood vessels. In an endeavor to establish the development of fungal infections, especially the one caused by steroid injections into the spine, the Center for Disease Control and Prevention conducted a respective study. The sample incorporated 40 respondents who were all patients. Among them, 16 were lethal cases. According to the study, the fungus known as Exserohilum rostratum moved upward via the cerebrospinal fluid along the spine. The said fungus then stayed at the bottom of the brain, leading to the development of meningitis. Cerebrospinal fluid was identified as a body fluid that filled the space that existed in the spine area close to the area where the contaminated drug was injected (Gholipour, 2013).

Exserohilum rostratum is a dark mold, which is normally found in the soil. However, this mold is little known in regard to how it develops infections, especially in human beings. This owes to the fact that few cases regarding this issue or disorder have been reported since 2012 when the first cases were reported. For the majority of infections, pathogens enter the blood instantly and begin travelling from one part and organ to the other. Interestingly, researchers from the Center for Disease Control were surprised to note that Exserohilum appeared to do this in opposite manner where it could first infect the brain and then enter the blood.

The study by the CDC established that the fungi could enter the cerebrospinal fluid and travel to the base of the human brain. From these parts, it gradually begins travelling into other parts of the body and invades the blood vessels. In the blood vessels, the fungus does not travel to other parts of the body since it does not have a chance to do so. This also owes to the fact that the disease is a fatal one. Another interesting aspect which has been found by the researcher is that the Exserohilum could not interfere with the brain’s neural tissue. Further, Exserohilum cannot invade the brain and is only confined to the meninges, which is found around the brain. The meninges are a word used in reference to the membrane layers, which cover the brain (Gholipour, 2013).

The study’s extensive methodology involved conducting autopsy on those who had died from fungal meningitis. The researchers established tissue decay and extensive bleeding, particularly near the brain’s base. In addition, the researchers also noted clots and inflammation around the blood vessels.

Prevention

One could avoid fungal meningitis in various ways. One of these is to avoid environments or soils that have a likelihood of containing fungus. Individuals with weak immune systems such as those infected with HIV virus should try as much as possible avoiding bird or bat droppings in suspicious environments. They should also avoid dusty activities and digging, especially in areas that harbor such fungi types as Coccidioides, Histoplasma, and Blastomyces. However, it should be considered that it is difficult for individuals who are infected with HIV to completely avoid exposure to the disorder.

School-going children that are found to be affected with fungal meningitis should be kept out of school until they feel better and are free from the condition. Rules for excluding affected children from attending school should be followed strictly. The school management should perform their role, while caregivers and parents should also perform their duties in this respect.

How Fungal Meningitis Differs from Viral or Bacterial Meningitis

There are notable differences between viral meningitis and bacteria. For instance, viral and bacterial meningitis appear to be more common when compared with fungal meningitis. Additionally, contrary to fungal meningitis, the virus and bacteria, which cause viral and bacterial meningitis, are contagious. However, these virus and bacteria may not necessarily lead to meningitis for those who are infected or exposed. Other differences are that fungal meningitis symptoms manifest themselves on a gradual basis when compared with bacterial meningitis. In addition, these symptoms just ease on for the most part. Further, the onset for these illnesses may not be as dramatic for bacterial meningitis whereby symptoms appear prominently and suddenly (Adler et al., 2006).

Bacterial meningitis is the most severe form of meningitis. The disorder can be fatal even with treatment. In case bacterial meningitis progresses for more than two days, it causes death to more than half of all patients. This is irrespective of the kind of treatment offered. In turn, it is not easy to determine the number of people who contract viral meningitis. This owes to the fact that the condition is not easily diagnosed and can easily be confused with other disorders such as flu. Furthermore, the prognosis is much better for viral meningitis when compared with bacterial meningitis. Most people are able to completely recover if associated symptoms are treated with simple medications. Since antibiotics cannot effectively treat viral infections, they are therefore not considered as effective medicines for viral meningitis (Adler et al., 2006).

Conclusion

Despite fungi providing a number of benefits to human beings, they do have the capability of becoming pathogens. It should also be considered that most of major fungal pathogens have the ability of causing meningitis. Fungal meningitis is brought out by filamentous and dimorphic fungus. Thus, this paper has focused on various aspects of fungal meningitis, which is a rare form of meningitis. Basic fungi such as Coccidioides, Histoplasma, Blastomyces, and Cryptococcus could be life-threatening if not carefully handled. In fact, fungal meningitis requires not only precise treatment, but also precise diagnosis, as well as careful strategies for optimizing the outcome.

Fungal meningitis is fatal if not treated carefully. Therefore, it is important for patients to plan their care. Moreover, caregivers should also understand the best ways of caring for such patients. Both patients and their caregivers should understand their conditions, as well as the best available means of treatment. Available treatment options should be discussed with caregivers and health practitioners who will then decide on what is suitable for them. Patients should understand that they always have a right to be involved in their treatment. Nonetheless, a patient should talk with the health practitioner prior to taking any medical regimen. The doctor will then determine if the particular regime is effective or safe for the patient. A lot of care is necessary when handling patients with fungal meningitis.