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Cryptococcosis in HIV-infected children

Surachai Likasitwattanakul1, Boonsom Poneprasert, Virat Sirisanthana

  • 1Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. slikasit@mail.med.cmu.ac.th

The Southeast Asian Journal of Tropical Medicine and Public Health
|May 27, 2005
PubMed

Insights

Cryptococcosis, particularly cryptococcal meningitis, is a significant concern in HIV-infected children. Early diagnosis via lumbar puncture and cryptococcal antigen testing is crucial for effective antifungal treatment.

Area of Science:

  • Pediatric Infectious Diseases
  • Mycology
  • Immunocompromised Host Infections

Background:

  • Cryptococcosis is a serious opportunistic infection in individuals with Human Immunodeficiency Virus (HIV).
  • Understanding the epidemiology and clinical presentation of cryptococcosis in pediatric populations with HIV is essential for timely diagnosis and management.

Purpose of the Study:

  • To determine the point prevalence of cryptococcosis among hospitalized HIV-infected children.
  • To describe the clinical characteristics, diagnostic findings, and outcomes of cryptococcosis in this population.

Main Methods:

  • Retrospective review of medical records of HIV-infected children diagnosed with cryptococcosis between January 1994 and December 2001.
  • Analysis of clinical data, cerebrospinal fluid (CSF) and serum cryptococcal antigen levels, India ink preparations, and routine CSF examinations.

Main Results:

  • The 8-year point prevalence of cryptococcosis was 2.97%.
  • Cryptococcal meningitis was the most common presentation (16 out of 19 reviewed cases).
  • Cryptococcal antigen testing in CSF and serum was highly sensitive (100%), while India ink was positive in 94%; routine CSF examination was normal in 50% of cases.

Conclusions:

  • Cryptococcal meningitis is the predominant clinical manifestation of cryptococcosis in HIV-infected children.
  • Prompt lumbar puncture with CSF analysis for cryptococcal antigen and culture is recommended for febrile HIV-infected children, especially those with neurological signs.

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