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[Meningeal cryptococcosis. Retrospective study of 7 cases]
1Département de Neurologie, Faculté de Médecine de Ho Chi Minh Ville, Vietnam.
Abstract:
In the analysis of medical records of 7 patients in one neurological service, different clinical aspects of cryptococcal meningitis such as diagnostic criteria, risk factors, clinical features, CSF features, and therapeutical features are reviewed. The finding on India ink preparation of Cryptococcus neoformans in the cerebrospinal fluid and the distinguishing clinical features of a chronic meningitis were the only diagnostic criteria in these 7 cases. Treatment with amphotericine B was the sole mean in the management of these cases. There were only two cases of complete cure, and 5 patients deceased. Intravenous associated with intrathecally injection of amphotericine B has been carried out in the two successfully treated patients.
Insights
This study reviewed 7 cryptococcal meningitis cases, finding India ink tests and chronic meningitis features crucial for diagnosis. Treatment with amphotericin B showed a low cure rate, highlighting challenges in managing this serious fungal infection.
Area of Science:
- Neurology
- Infectious Diseases
- Mycology
Background:
- Cryptococcal meningitis is a serious fungal infection, particularly affecting immunocompromised individuals.
- Early and accurate diagnosis is critical for effective management and improved patient outcomes.
- Understanding the clinical and cerebrospinal fluid (CSF) features aids in differentiating it from other meningitis types.
Observation:
- The analysis reviewed medical records of 7 patients diagnosed with cryptococcal meningitis.
- Diagnostic criteria relied on India ink preparation identifying Cryptococcus neoformans in CSF and chronic meningitis features.
- Treatment exclusively involved amphotericin B, with varied administration routes.
Findings:
- Only India ink preparation and chronic meningitis clinical features were used for diagnosis in these cases.
- Amphotericin B was the sole therapeutic agent employed.
- A low cure rate was observed, with only 2 out of 7 patients achieving complete recovery; 5 patients deceased.
- Intravenous and intrathecal amphotericin B administration was used in the two successfully treated patients.
Implications:
- The diagnostic approach in these cases was limited, underscoring the need for comprehensive diagnostic strategies.
- The high mortality rate associated with amphotericin B treatment emphasizes the severity of cryptococcal meningitis.
- Combined intravenous and intrathecal amphotericin B may improve treatment success, warranting further investigation.