Tuberculous meningitis. Clinical characteristics and comparison with cryptococcal meningitis in patients with human

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J Sánchez-Portocarrero1, E Pérez-Cecilia, A Jiménez-Escrig

  • 1Department of Neurology, Hospital Universitario San Carlos, Madrid, Spain.

Archives of Neurology
|July 1, 1996
PubMed
Abstract

Insights

Tuberculous meningitis was the most common cause of meningitis in HIV patients, often linked to injecting drug use. Cryptococcal meningitis indicated more advanced HIV infection stages.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Meningitis is a significant opportunistic infection in individuals with human immunodeficiency virus (HIV).
  • Understanding the specific etiologies of meningitis in HIV patients is crucial for effective management and treatment strategies.

Purpose of the Study:

  • To investigate the prevalence and etiological agents of meningitis in a cohort of patients with HIV infection.
  • To identify risk factors and clinical characteristics associated with different types of meningitis in HIV-positive individuals.

Main Methods:

  • A prospective study was conducted between 1988 and 1992 at a tertiary care university hospital in Madrid, Spain.
  • The study included 142 HIV-infected patients, with a focus on neurologic complications.
  • Meningitis diagnoses were confirmed, and causative agents were identified, with comparative analysis based on HIV transmission routes and CD4+ cell counts.

Main Results:

  • Meningitis was diagnosed in 33 patients (23%), accounting for 36 episodes.
  • Tuberculous meningitis was the most frequent type, identified in 17 cases (47%), with a significant association with injecting drug use as the HIV transmission route (P = .03).
  • Cryptococcal meningitis occurred in 7 cases (19%) and was associated with lower mean CD4+ cell counts (P = .02), suggesting occurrence in advanced HIV stages.

Conclusions:

  • Tuberculous meningitis is a primary cause of meningitis in HIV-infected individuals, particularly those with a history of injecting drug use.
  • Cryptococcal meningitis is indicative of more advanced stages of HIV infection and presents with distinct clinical features.
  • These findings highlight the importance of considering specific pathogens based on patient risk factors and disease progression in HIV-associated meningitis.

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