Meningitis is an infection of the meninges, the protective membranes that cover the brain and the spinal cord. Meningitis can be caused by bacteria, viruses and fungi, according to the U.S. Centers for Disease Control and Prevention. Cryptococcal meningitis is caused by the fungus Cryptococcus. There are 30 strains of Cryptococcus, and one that often causes disease is Cryptococcus neoformans.
"Most of us have been exposed to Cryptococcus neoformans. It is ubiquitous in the environment, associated with trees, bird guano and soil. Infection is thought to occur from the inhalation of spores," Day said.
People can be infected for years without knowing it, according to Day. But, if someone who's infected has weakened immunity, the infection can then start to wreak havoc. Common ways people become immune-suppressed are through an HIV infection, taking immune-suppressing medications for organ transplantation, or taking immune-system altering medications for chronic inflammatory diseases, Day explained.
The current study included 299 people with cryptococcal meningitis who were randomly assigned to one of three treatment regimens: amphotericin B alone for four weeks; amphotericin B plus flucytosine for two weeks; or amphotericin B plus fluconazole for two weeks. People in the second and third groups were also given eight weeks of follow-up therapy with fluconazole.
The investigators found that combination therapy with amphotericin B and flucytosine resulted in a 40 percent lower risk of death compared to amphotericin therapy alone. Combination therapy with fluconazole didn't appear to affect survival rates, according to the study.
The combination therapy with flucytosine also resulted in lower levels of Cryptococcus<
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