Fungal Meningitis Q&A
In a few cases, Schaffner says, the first indication that anything was wrong was a stroke. “Patients can present with difficulty speaking, difficulty with their sense of balance or walking,” he says.
How long does it take to get sick?
“There’s a big range,” Park says. “We’ve had people who’ve gotten sick less than a week after their injection, and we’ve had people that have gotten sick, the longest now is up to 42 days,” he says.
“It’s important for people to stay vigilant for symptoms because we don’t know enough to reassure people that they’re safe,” says Park.
I’ve had a “meningitis” vaccine. Will that protect me?
The meningococcal vaccine protects against bacteria that cause meningitis and other meningococcal disease. It doesn’t protect against fungal infection.
How is fungal meningitis diagnosed?
Doctors insert a needle into the lower part of the back to collect a fluid sample. The test is called a lumbar puncture. The fluid is sent to a lab, where technicians culture it to see if fungus will grow.
It’s difficult to get fungus to grow under laboratory conditions, however, and yesterday the CDC said that some people who get meningitis will test negative for fungus.
In those cases, Schaffner says, doctors look for other signs of an infection in the spinal fluid to make the diagnosis.
“There would be an elevated number of white blood cells. The protein concentration would be high and the glucose, or sugar concentration, would be low. So that would indicate that the patient would have inflammation of those membranes surrounding the brain, and we would know that something is wrong, and we would treat the patient for meningitis,” he says.
How is fungal meningitis treated?
It’s a slow process.
“[The treatments] don’t kill the fungus. They just inhibit further growth. Then you have to have your immune system do the rest of the work,” Ostrosky-Zeichner says.
There are two drugs that are being used to treat infected patients: an older drug called amphotericin B and a newer drug called voriconazole.
Amphotericin B comes in several forms. One form of the drug is currently unavailable, according to a list of drug shortages kept by the American Society of Health-System Pharmacists. Other forms have been subject to shortages in the past.
Doctors say they have enough amphotericin to treat patients who need it. But they are worried they could run out if the outbreak gets worse.
“That’s in the back of everyone’s mind. As the case count continues to increase, more patients will need to be treated and the treatment is prolonged,” Schaffner says. “We may be talking about months for some of these patients."