Differential Diagnosis for Meningitis in Someone with AIDS
- Single most likely diagnosis
- Cryptococcal meningitis: This is the most common cause of meningitis in patients with AIDS, particularly those with CD4 counts below 100 cells/μL. Cryptococcus neoformans is an opportunistic fungus that can cause severe and life-threatening meningitis in immunocompromised individuals.
- Other Likely diagnoses
- Toxoplasmosis: Toxoplasma gondii can cause meningitis or encephalitis in patients with AIDS, especially those with CD4 counts below 200 cells/μL.
- Tuberculous meningitis: Mycobacterium tuberculosis can cause meningitis in patients with AIDS, particularly in those from endemic areas or with a history of tuberculosis.
- Cytomegalovirus (CMV) meningitis: CMV can cause meningitis or encephalitis in patients with AIDS, especially those with CD4 counts below 100 cells/μL.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Listeria monocytogenes meningitis: Although less common, Listeria monocytogenes can cause severe meningitis in immunocompromised individuals, including those with AIDS.
- Streptococcus pneumoniae meningitis: Bacterial meningitis, including S. pneumoniae, can occur in patients with AIDS and may have a higher mortality rate due to immunocompromised status.
- Rare diagnoses
- Candida meningitis: Candida species can cause meningitis in patients with AIDS, particularly those with a history of neurosurgery, central nervous system devices, or prolonged antibiotic use.
- Histoplasma capsulatum meningitis: Histoplasma capsulatum can cause meningitis in patients with AIDS, especially those from endemic areas or with a history of histoplasmosis.
- Coccidioides immitis meningitis: Coccidioides immitis can cause meningitis in patients with AIDS, particularly those from endemic areas or with a history of coccidioidomycosis.