Fungal Meningitis Treatment: What Works, What to Avoid

When fungal meningitis, a rare but life-threatening infection of the membranes around the brain and spinal cord caused by fungi. It’s not contagious like viral or bacterial meningitis, but it’s just as dangerous if ignored. Most cases happen in people with weak immune systems — from diabetes, cancer treatment, or long-term steroid use. Unlike bacterial meningitis, which hits fast, fungal meningitis creeps in over weeks. That’s why it’s often missed until it’s advanced.

There are two main types you’ll see in medical reports: Cryptococcus meningitis, the most common cause, often linked to bird droppings and soil, and Candida meningitis, usually tied to hospital stays, IV lines, or recent surgery. Both need strong antifungals — no antibiotics here. The go-to first-line drug is amphotericin B, given intravenously for weeks. It’s harsh — causes fever, kidney damage, chills — but it’s the only thing that reliably kills the fungus. After that, patients switch to fluconazole, taken orally for months, sometimes over a year. Skipping the full course? That’s how relapses happen.

Some patients need surgery to drain fluid buildup around the brain. Others need help managing side effects — low potassium, liver stress, or nerve pain. Monitoring isn’t optional. Blood tests, spinal taps, and brain scans are part of the routine. And here’s the kicker: you can’t treat this at home. If you’ve had a spinal injection, recent brain surgery, or live in areas with lots of dust (like the Midwest or Southwest U.S.) and you get a headache that won’t quit, fever, stiff neck, or confusion — don’t wait. Go to the ER. Fungal meningitis doesn’t respond to over-the-counter meds. It needs hospital-level care.

What you won’t find in the news? A lot of the cases in recent years came from contaminated steroid injections — a pharmacy error that spread across states. That’s why knowing your medication source matters. If you’re getting shots for back pain, ask if the drug was made in a licensed facility. Not all compounding pharmacies follow the same rules.

Below, you’ll find real patient-focused guides on antifungal drugs, how they affect your liver and kidneys, what to watch for during treatment, and how to avoid dangerous interactions with other meds you might be taking. No fluff. Just what you need to know if you or someone you care about is facing this.