[AIDS-related cryptococcosis: diagnostic aspects, prognostic and therapeutic implications]

Diagnostic techniques of AIDS-related cryptococcosis were assessed in a series of 43 HIV-infected patients, and microbiological features were correlated to the clinical course and outcome of disease. Polysaccharide antigen detection was the most sensitive method for central nervous system infection, followed by direct microscopy and culture: in 4 patients this visceral mycosis was initially diagnosed by the detection of isolated cerebrospinal fluid antigen. Thirty-one patients out of 43 suffered from disseminated infection (with positive blood cultures and/or antigenemia). The occurrence of clinical relapses, a lethal outcome, and time to relapses or to death, did not differ significantly between patients with isolated central nervous system and those with disseminated cryptococcosis.