Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.Dear Doc:
Two weeks ago my girlfriend was admitted to the hospital and diagnosed with fungal meningitis. The diagnosis was confirmed by analysis of her spinal fluid via the spinal tap.
Additional blood work indicates that she has progressed to full blown AIDS with a CD4 count of 200. Her Viral Load results are not available.
She was treated immediately for acute fungal meningitis while hospitalized, and now has been released to her home where she is continuing her treatment with the following oral medications: Azithromax, Diflucan, Bactrim. Based upon these medications I am assuming that her fungus is most likely of the Cryptococosis variety and will remain a life long battle against chronic Crypto infection.
My questions are:
1. Is she infectious / contagious to others?
2. I too am HIV + with a 280 CD4 Count and VL undetectable. Am I at risk of contracting this disease from her?
3. How is it transmitted?
4. What precautions should I take when I visit her (if any are necessary)?
Cryptococcus is a fungus found throughout the world. In the US it is more common east of the Mississippi and is often associated with pigeon droppings. Spores are inhaled and colonize the airways from throat to lungs initially before spreading to the brain.
The vast majority of cryptococcal meningitis occurs in patients with less than 100 t-cells, so I am a little surprised that you said your girlfriend's CD4 count was 200. (Maybe you meant that her count was less than 200?)
Anyway, you should not feel at risk for cryptococcus with a CD4 count of 280. More importantly, cryptococcus is not transmitted from human to human, so neither you nor visitors need to worry.
060629
ASKD060615
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