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Cryptococcal infection in patients with clinically diagnosed meningitis in a tertiary care center

K N Prasad1, J Agarwal, V L Nag

  • 1Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow - 226014, India. knprasad@sgpgi.ac.in

Neurology India
|December 4, 2003
PubMed

Insights

Cryptococcal meningitis affects 16.6% of meningitis cases, including immunocompetent individuals. Early investigation for this infection is crucial due to its high mortality rate.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Mycology

Background:

  • Meningitis is a serious central nervous system infection.
  • Cryptococcal infection is a significant cause of meningitis, particularly in certain populations.
  • Identifying risk factors and outcomes is essential for effective management.

Purpose of the Study:

  • To determine the prevalence of cryptococcal meningitis.
  • To identify associated risk factors and therapeutic outcomes.
  • To emphasize the need for investigating cryptococcal infection in all meningitis cases.

Main Methods:

  • Retrospective analysis of 326 clinically diagnosed meningitis cases over 5.5 years.
  • Identification of cryptococcal meningitis using smear examination, culture, and cryptococcal antigen latex agglutination test.
  • Review of medical records for 45 confirmed cryptococcal meningitis patients.

Main Results:

  • Cryptococcal meningitis was identified in 16.6% (54/326) of cases.
  • Risk factors included human immunodeficiency virus (HIV) infection (28.9%), renal transplant (20%), diabetes (8.9%), and systemic lupus erythematosus (2.2%).
  • Notably, 40% of patients were immunocompetent.

Conclusions:

  • Cryptococcal meningitis is associated with high mortality (22.2% in this study).
  • Symptoms are often indistinguishable from other CNS infections.
  • Investigation for cryptococcal infection is recommended for all meningitis patients, regardless of immune status.

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