Cryptococcal Meningitis: A Clinicopathological Account of Seven Cases Encountered in a Military Setting

The clinicopathological profile of 7 cases of Cryptococcal meningitis encountered over one year period in a military hospital has been described. Severe persistent headache was the main form of presentation followed by features of progressive ill-health. Age range of cases was 34-55 years (mean 40.8 years). All were males and 6 were serving soldiers. Duration of symptoms ranged from 10 days to 6 weeks. Six patients were positive for HIV-1 antibodies. This was the initial presentation of AIDS in 6 patients accounting for 10.34% among all cases of HIV infection during that year. Both clinical and laboratory findings were subtle. Nuchal rigidity was rare, cerebro spinal fluid (CSF) cell count and protein level was normal in 3 out of 7 cases. Although culture for Cryptococcus was positive in all, it took 10 days to grow in 2 cases. India-ink stain showed scanty number of organisms in 3 cases. Low cell counts in CSF and presence of associated hyponatremia appear to be bad prognostic indicators in Cryptococcal infections of central nervous system. Latex agglutination test is a worthwhile screening test.