Fungal meningitis

All patients should be counseled regarding the importance of adherence to antifungal maintenance therapy and told to report any recurrence of symptoms. Patients should be informed of the need to monitor response by blood and cerebrospinal fluid analysis and the possibility of relapse.

HIV-infected patients who have been treated for cryptococcal meningitis should be warned of the possible occurrence of cryptococcal immune reconstitution syndrome (CM-IRIS), usually 1 to 2 months after starting antiretroviral therapy.

Patients treated for coccidioidal meningitis need to be advised that therapy and follow-up is lifelong, and of the high risk of relapse if treatment is discontinued or interrupted.