Role of environmental factors in Cryptococcal meningitis in immunocompetent individuals

Cryptococcal Meningitis (CM) is caused by members of the yeast species, Cryptococcus neoformans. Although C.neoformans can cause infection in any part of the body, the fungus prefers to invade regions of the lungs and CNS [1]. The infection is thought to be acquired through the respiratory tract, and reaches the meninges through the blood circulation [1]. Symptoms of CM include headaches, malaise, fever, and changing psycho-mental stability. CM is most commonly recognized as an opportunistic infection in immunocompromised individuals, especially those suffering from HIV/AIDS, liver cirrhosis or sarcoidosis [2]. Hence, CM risk is usually overlooked or totally ignored during the differential diagnosis of immunocompetent individuals who present meningitis like symptoms. Recent reports have indicated rising prevalence of CM in individuals who are believed to be immunocompetent, resulting in delayed or misdiagnosis of such patients [3]. Other factors are emerging to be important determinants when diagnosing a patient with meningitis like symptoms. Such factors include environmental factors originally believed to be important in Africa or in tropical environments. Environmental factors (as they relate to CM) can be defined as any factor originating from the environment that results in immunodeficiency, either by a significant decrease in white blood cells count or by interfering with normal immunological response of the body.