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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 |
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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. |