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Cryptococcal meningitis in acquired immunodeficiency syndrome

S P Kalra, D S Chadha, A P Singh

    The Journal of the Association of Physicians of India
    |April 25, 2000
    PubMed
    Abstract

    Insights

    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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