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Cryptococcal meningitis in people living with human immunodeficiency virus in Nepal: Perspectives from resource

Supriya Sharma1, Jyoti Acharya2, Nisha Rijal2

  • 1Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal.

Mycoses
|September 6, 2022
PubMed

Insights

Early diagnosis of cryptococcal meningitis in people living with HIV (PLHIV) is vital. Cryptococcal antigen tests and India ink staining are effective laboratory methods for confirming meningitis in resource-limited settings.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Public Health

Background:

  • Cryptococcal meningitis is a significant opportunistic infection in people living with HIV (PLHIV).
  • Timely diagnosis and treatment are essential for improving outcomes in PLHIV with suspected meningitis.
  • Resource-limited settings face challenges in diagnosing cryptococcal meningitis effectively.

Purpose of the Study:

  • To evaluate laboratory techniques for diagnosing cryptococcal meningitis in PLHIV in a resource-limited setting.
  • To compare the diagnostic performance of India ink staining, cryptococcal antigen lateral flow assay, and fungal culture.
  • To identify the most suitable diagnostic methods for early detection of cryptococcal meningitis in PLHIV.

Main Methods:

  • A prospective cross-sectional study involving 72 PLHIV with suspected meningitis.
  • Cerebrospinal fluid (CSF) samples were analyzed using India ink staining, cryptococcal antigen lateral flow assay, and fungal culture.
  • Standard laboratory protocols were followed for all diagnostic tests.

Main Results:

  • Cryptococcus was detected in 22.22% of cases by any method.
  • Cryptococcal antigen lateral flow assay identified 19.44% of cases, India ink staining 16.66%, and culture 8.33%.
  • The median age of confirmed cases was 39 years, with males constituting 87.5%.

Conclusions:

  • A high prevalence of cryptococcal meningitis among PLHIV necessitates early microbiological diagnosis.
  • Cryptococcal antigen detection immunoassay is recommended as the priority test for diagnosing cryptococcal meningitis in PLHIV.
  • India ink staining offers a simple and economical alternative for resource-limited settings.
Keywords:
CSF cultureIndia ink stainingcryptococcal antigencryptococcal meningitishuman immunodeficiency virus

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