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Cryptococcus meningitis


It develops in patients who are immune compromised e.g. HIV-positive patients with low CD4 cell count.  

Diagnostic criteria

Headache, fever, intolerance to light and sound, neck stiffness, vomiting, seizures, deafness and blindness

In advanced stages it may present with confusion, altered consciousness and coma. 

Non-Pharmacological Treatment

Refer to section on bacterial meningitis  


Pharmacological Treatment: 

Treatment is in 3 phases: 

Phase 1: Induction phase 


  • Amphotericin B 0.7mg/kg/day IV            


  • Flucytosine 100mg/kg/day administered orally for 14 days   


  •  Fluconazole 1200mg IV/(PO) once daily for 14 days 


Phase 2: Consolidation phase 

  • Fluconazole 400mg day for 8 weeks or until CSF is sterile.  


Phase 3: Suppressive phase 

  • Fluconazole 200mg per day until CD4 more than 350 



LP is done for diagnostic and therapeutic for cryptococal meningitis.

Cryptococal antigen test should be done as there are cases of negative India ink results with cryptococal meningitis 

Updated on, 27.10.2020


1. STG

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