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Cryptococcal meningitis in acquired immunodeficiency syndrome
The Journal of the Association of Physicians of India
|April 25, 2000
Summary
Cryptococcal meningitis (CM) is a frequent opportunistic infection in individuals with acquired immunodeficiency syndrome (AIDS). Early diagnosis and treatment are crucial, as disseminated disease and raised intracranial pressure indicate a poor prognosis.
Area of Science:
- Infectious Diseases
- Neurology
- Immunology
Background:
- Cryptococcal meningitis (CM) is a significant opportunistic infection in patients with acquired immunodeficiency syndrome (AIDS).
- Understanding the clinical presentation and outcomes of CM in this population is vital for effective management.
Purpose of the Study:
- To investigate the clinical course and patient outcomes for cryptococcal meningitis (CM) in individuals with acquired immunodeficiency syndrome (AIDS).
Main Methods:
- Retrospective analysis of 431 human immunodeficiency virus (HIV)-infected patients admitted during the study period.
- Diagnosis of CM confirmed by positive India ink preparation or fungal culture of cerebrospinal fluid (CSF).
- Treatment involved amphotericin B followed by oral fluconazole for responding patients.
Main Results:
- Fifteen out of 431 HIV-infected patients were diagnosed with CM, predominantly with subacute presentations.
- Diagnosis was consistently established via CSF analysis (India ink or fungal culture).
- Seven patients showed complete response, two were lost to follow-up, and six died; raised intracranial tension and disseminated disease correlated with poor prognosis.
Conclusions:
- Cryptococcal meningitis (CM) is a common opportunistic fungal infection in patients with AIDS, necessitating high clinical suspicion and mycological surveillance.
- While many patients respond to amphotericin B and fluconazole, those with disseminated infection, altered sensorium, or raised intracranial pressure at presentation face poorer outcomes.
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