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Cryptococcal meningitis in a tertiary care hospital

Taneja Juhi1, Mishra BibhaBati, Bhargava Aradhana

  • 1Department of Microbiology, GB Pant Hospital, New Delhi, India.

Nihon Ishinkin Gakkai Zasshi = Japanese Journal of Medical Mycology
|May 12, 2009
PubMed

Insights

Early diagnosis of cryptococcus meningitis is crucial. Prompt laboratory testing and clinical suspicion significantly reduce patient mortality and morbidity.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Medical Mycology

Background:

  • Cryptococcus meningitis poses a significant diagnostic challenge, particularly in immunocompromised individuals.
  • Review of seven cases from a tertiary care hospital (2004-2007) highlights clinical and diagnostic features.

Observation:

  • Headache was the primary symptom in 85.7% of patients.
  • Cerebrospinal fluid (CSF) cytology and biochemistry were often inconclusive.
  • CT/MR imaging revealed a range of findings, from normal to granulomas.

Findings:

  • Diagnosis relied on India ink (100%), CSF cryptococcal antigen (100%), and CSF culture (85.7%).
  • Common comorbidities included HIV, diabetes mellitus, and idiopathic CD4+ lymphocytopenia.
  • Six patients achieved successful treatment with amphotericin B.

Implications:

  • A high index of clinical suspicion is vital for early cryptococcus meningitis detection.
  • Timely laboratory diagnosis is essential to reduce morbidity and mortality.
  • Effective treatment with amphotericin B can lead to favorable outcomes.

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