Abstract: Objective  To analyze the diagnosis and treatment of refractory fungal meningitis, so as to further improve the diagnosis and treatment of the disease.Methods  Retrospective study was used to analyze the process of diagnosis and treatment of three cases refractory fungal meningitis, and relative literature was reviewed.Results  Case one patient admitted with headache and limb weakness. The patient did  not get well via antitubercular and antiviral treatment. Rare type of fungi was found in CSF through repeated lumbar puncture. The patient improved via antifungal treatment. Case two patient admitted with headache, and cryptococcus was found in CSF. The lung CT showed pulmonary tuberculosis, and the patient recovered via antifungal and antitubercular treatment. Case three patient admitted with headache, and cryptococcus was found in CSF. Because of Intracranial hypertension treated with Ommaya implantation, venous sinus thrombosis treated with anticoagulation combined with antifungal drugs, the patient's clinical symptoms improved.Conclusion  Refractory fungal meningitis is a kind of meningitis with poor prognosis and high mortality. Early diagnosis, active treatment of protopathy and control of intracranial hypertension are the key to improve the prognosis of this disease.

Key words: meningitis, , fungal, intracranial hypertension, early diagnosis