What is fungal meningitis?

On this page you’ll find an overview of meningitis caused by different fungi, including symptoms, treatment and possible after-effects.

• Fungal meningitis is a rare cause of meningitis. It most commonly affects people with weakened immune systems.
• Cryptococcus is the most common cause of fungal meningitis globally.
• Fungal meningitis can cause serious neurological impairment or death if left untreated.
• Fungal meningitis develops much more slowly than other types of meningitis.

What is fungal meningitis?

Fungal meningitis is the swelling of the lining of the brain and spinal cord (meninges) caused by a fungal infection.

Several types of fungi can cause meningitis. They can be found in the environment and on living things.

Meningitis-causing fungi found in the environment include:

• Cryptococcus, which is the most common cause of fungal meningitis globally. It’s found all over the world in soil, particularly soil that contains large amounts of bird droppings. It causes more than 180,000 deaths worldwide every year and contributes to 15% of all AIDS-related deaths globally.¹
• Aspergillus, which is found in decaying leaves, compost and plants globally.
• Histoplasma, which is most commonly found in soil in some parts of the United States, Canada, Mexico, Central and South America.
• Blastomyces, which is found in some parts of the USA, Canada, Africa and India, particularly in moist soil near woodland and along waterways.
• Coccidioides, which is found in the soil in Southern California, Southern Arizona, Northern Mexico and Central and South America.

Candida is a fungus naturally found living in and on the body. Meningitis can be caused by two different variants of Candida:
 

• Candida albicans, which is naturally found on the skin and in the mouth, throat, gut and vagina of healthy people.
• Candida auris, which has been associated with infections acquired in hospitals. This fungus has been named a priority pathogen by the World Health Organisation (WHO). This is because it’s often resistant to treatment and cases are rising globally.

Fungal meningitis kills or causes serious neurological impairment if left untreated. But disease progression is usually much slower than in cases of bacterial meningitis, so there’s more time to get life-saving treatment.

What are the symptoms of fungal meningitis?

In cases of fungal meningitis, symptoms tend to appear more gradually than with other causes of meningitis. They can sometimes progress over several weeks.

Early symptoms of fungal meningitis can look like milder, more common infections.

Symptoms may include: 

• Fever.
• Vomiting.
• Severe headache.
• Stiff neck (less common in young children).
• Dislike of bright lights.
• Seizures (fits).
• Confused / delirious.
• Very sleepy / vacant /difficult to wake.

Symptoms in babies and very young children can be slightly different. Their symptoms may include:

• High temperature (warning: could be normal or low in babies under three months old).
• Irritability.
• Vomiting / refusing to feed.
• A high-pitched cry.
• A stiff body with jerky movements or else floppy and lifeless.
• Very sleepy / staring expression / too sleepy to wake up.
• Tense or bulging soft spot on the top of their head.

Not everyone with meningitis will get all these symptoms. 

Check regularly on someone who is unwell. Always trust your instincts and get medical help straight away if you or someone you know is seriously ill.

Read more information about the symptoms of meningitis. 

How do you get fungal meningitis?

You can develop fungal meningitis if exposure to a fungus leads to infection. In most healthy people, being exposed to fungi does not lead to an infection. If you have a weakened immune system, you’re at higher risk of becoming unwell.

Fungi that live in soil can enter your body if you breathe in air and dust particles that contain the fungus. Breathing in the fungus can initially cause an infection in the lung. It goes on to cause meningitis if the fungus reaches the cerebrospinal fluid (CSF), which surrounds and cushions the brain and spinal cord.

Newborn babies can be exposed to Candida albicans in their first weeks of life. Babies with weak immune systems are particularly vulnerable. They can become seriously unwell with meningitis and sepsis if they are exposed.

Candida auris can cause fungal meningitis if you have contact with contaminated medical devices. Outbreaks of other types of fungal meningitis have been associated with contaminated anaesthesia and steroid injections.²

Who can get fungal meningitis?

Fungal meningitis can affect anyone. People with a weakened immune system are at higher risk, for example people with HIV or undergoing treatment for cancer.

Fungal meningitis is more common in areas such as sub-Saharan Africa, where high proportions of the population are HIV-positive. It’s also more common in the Americas and parts of Asia where the fungi Histoplasma, Coccidioides or Blastomyces are found.

Premature babies with low birth weight are at increased risk of getting severe infections caused by Candida albicans.

How is fungal meningitis treated?

Fungal meningitis is treated with anti-fungal medication. This is usually given directly through a vein while you’re in hospital. 

Once you leave hospital, you may also need to take anti-fungal medication orally for a while. 
The medication you take and how long you need it for will depend on the type of fungus that caused the infection and how well you are.

Some patients who have been diagnosed with fungal meningitis may need to take medication for the rest of their lives. Most types of fungal meningitis will require patients to take medication for at least a few months

What are the after-effects of pneumococcal meningitis?

Fungal meningitis affects everyone differently. Most people make a full recovery without any lasting problems. But in some cases, it can cause ongoing problems which may need further treatment and support.

The possible after-effects of fungal meningitis include:

• Learning and intellectual disabilities such as memory loss, lack of concentration or issues with thinking and problem solving.
• Clumsiness and co-ordination problems.
• Headaches.
• Deafness, hearing problems, tinnitus, dizziness or loss of balance.
• Epilepsy or seizures.
• Weakness, paralysis or spasms.
• Loss of sight or vision problems.
• Hydrocephalus (fluid on the brain).
• Mental health issues and changes to personality or behaviour.
• Difficulties with sleep.
• Fatigue.
• Anxiety and depression.

Long term after-effects of meningitis are usually identified while you are still in hospital. For very young babies it might not be possible to tell if they have any long-term effects until they get older.

Is there any follow-up care after recovery from fungal meningitis?

Treatment for fungal meningitis usually goes on for a long time. There should be opportunities for you to discuss any concerns you have about your recovery with the doctors treating you.

Depending on your needs and your local health services, you may be referred to different teams of doctors and specialists to treat any ongoing after-effects that you have following fungal meningitis.  

Follow-up care for babies and children is particularly important, along with tracking their development as they get older. Some long-term neurodevelopmental complications may not be noticeable until children reach certain milestones. Make sure to discuss any concerns you have about your child’s development with doctors.

Read more about the follow-up care after recovery from meningitis.

Can we prevent fungal meningitis?

There are no vaccines that prevent fungal meningitis.

You may be advised to take preventative anti-fungal medication if you’re at higher risk of being affected and you live in a part of the world where exposure to the fungi is more likely.

The fungi that can cause meningitis are commonly found all around us, so they’re difficult to avoid. But it’s a good idea for people living in places where there’s a higher risk of exposure to avoid situations and activities that would expose them to dirt or dust.

In hospitals, infection control procedures make sure that the hospital environment is as safe as possible for all patients, especially those with weakened immune systems.

Can I get a vaccine to protect me against fungal meningitis?

No, there is no vaccine available that protects against fungal meningitis.

Author: Meningitis Research Foundation.
Reviewed by: Natalie King, Meningitis Research Foundation Ambassador.
Published: 2 April 2025.