Fungal Meningitis Outbreaks: Caring for Yourself and Others

Key points

  • Outbreaks of fungal meningitis linked to healthcare procedures are very rare.
  • Fungal meningitis is a deadly fungal infection of areas around the brain and spinal cord.
  • People at risk should seek testing and treatment immediately.
  • If you had a healthcare procedure linked to an outbreak, follow the steps listed below.
Illustration showing a doctor admitting a patient to the emergency room at a hospital.

Taking immediate action

If you are at risk for fungal meningitis, go the nearest emergency room, even if you do not have symptoms.

If you do not have symptoms or symptoms are mild, testing and treatment could prevent severe illness or death. Once symptoms start, fungal meningitis is harder to treat. Do not wait. Every moment counts.

Illustration showing a doctor admitting a patient to the emergency room at a hospital.
If you are at risk for fungal meningitis, go to the Emergency Room.

Tips for before you go to the ER

  • Write down the phone number of your local health department.
    • ER staff or healthcare providers can call if they have questions.
  • Bring an overnight bag in case you need to stay at the hospital.
  • Tell at least one friend or family member.
    • They can bring clean clothes and help with tasks at home, if needed.
  • Plan on staying at the ER until you are seen by a healthcare provider.
    • Wait times can be several hours.

Call 911‎

If someone is having symptoms of fungal meningitis or experiencing a life-threatening emergency, call 911 or go to the ER without delay.

Getting tested

Illustration showing a doctor performing a spinal tap on a patient.
A spinal tap is used to test for fungal meningitis.

When you arrive at the ER, tell staff that you need to be tested for fungal meningitis. Tell them about your recent medical care or procedures and possible exposure during an outbreak.

Spinal tap

Healthcare providers will test you for fungal meningitis by performing a spinal tap. You may be nervous about the test, but most people do not feel pain when they have a spinal tap. Some people may feel pressure or a sharp feeling when the needle is inserted. You may be less worried when you know what to expect with each step. Remember that this test could be lifesaving.

What to expect

  • The healthcare providers performing your spinal tap will:
    • Ask you to either lay on your side with your knees pulled up against your chest or sit up and lean forward against some pillows.
    • Clean an area around your lower spine with a liquid or moist wipes that kill germs.
    • Use a tiny needle to inject a solution into the skin to make that area temporarily numb.
    • Insert a hollow needle into a small space around your spine to collect fluid called cerebrospinal fluid (CSF).
  • The fluid will be tested in a laboratory to determine if you have fungal meningitis.
  • Test results normally come back quickly but may take longer.

Test results

  • If you test negative for fungal meningitis:
    • It is possible to test negative during the early phases of infection (called a false negative).
    • Your healthcare provider may ask you to come back in 2 weeks to repeat the spinal tap.
    • Watch for symptoms for at least 30 days after your spinal tap, whether or not you are scheduled to return for a second test.
    • Return to the emergency room immediately, if you develop new or worsening symptoms (like fever, headache, stiff neck, nausea, vomiting, light sensitivity, confusion).
  • If you test positive for fungal meningitis:
    • You will be admitted to the hospital to begin treatment.
Illustration showing a doctor medically treating a patient in a bed.
Fungal meningitis is treated with IV antifungal medication.

Facing challenges

What to expect during treatment

When you are tested and get treatment early, your fungal meningitis can be cured.

In the hospital

  • You will need to spend at least 2 weeks receiving treatment in the hospital. You will likely receive two antifungal medicines by IV (intravenous): amphotericin B and voriconazole.
    • Possible side effects for amphotericin B include fever, chills, nausea, tiredness, and weakness.
    • Possible effects for voriconazole include vision changes, black stools, itching, and blistering or peeling skin.
  • Your healthcare team will order simple blood tests to see how your kidneys and liver are functioning while on these medicines.
  • After 2 weeks, you may be able to switch to taking one oral medicine.
  • Spinal tap and blood tests will be repeated to determine when you can go home to continue oral treatment.

Important reminder‎

Staying in the hospital can be challenging, and it may be harder if you never developed symptoms.

Remember that the time you spend staying in the hospital and taking antifungal medicines at home is protecting you from severe complications and death. It may help you stay safe and healthy for years to come.

If you stop treatment too early or do not take medicines as prescribed, the infection can come back and cause severe disease and even death.

At home

  • You may need to continue to take oral medicines for at least 3-6 months.
  • Continue to follow up as an outpatient as instructed by your healthcare provider.
  • If you have fungal meningitis, treatment includes at least 2 weeks in the hospital and at least 3–6 months of medicine at home after you leave the hospital.
  • The first few days or weeks that you are infected, you may not feel sick. Without testing and treatment, you could quickly become very ill.
  • Early testing and treatment, especially before symptoms start, can prevent serious illness, complications, and death.
Illustration showing several symptoms of fungal meningitis.
Symptoms include fever, headache, stiff neck, nausea, vomiting, light sensitivity, and confusion.
  • Common symptoms include fever, headache, stiff neck, nausea, vomiting, light sensitivity, and confusion.
  • Serious complications include strokes, bleeds in the brain, fluid in the brain, and too much pressure in the brain.
  • Fungal meningitis infections cannot spread person to person.