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Abstract

Cryptococcal infection is common in immunocompromised patients. Its occurrence in immuno-competent patients is rare. We report here 3 cases of neuromeningeal cryptococcosis in patients without any immunosuppressive documented factors. They were respectively 25, 36 and 50 years old presenting clinical signs of chronic meningo-encephalitis. The HIV test was negative for all of them and the CD4 counts were normal. One patient died on the seventh day of the treatment with amphotericin B; the second was discharged on parents' request, while the third patient improved with intravenous fluconazole. This study suggests that when facing a sub-acute or chronic meningitis, an investigation for cryptococcal infection is recommended as before AIDS epidemic.

Neuromeningeal cryptococcosis in sub-Saharan Africa: Killer disease with sparse data

“…While the NMC is currently a real marker of HIV infection,[ 8 ] it remains true that this condition also affects immunocompromised patient by other diseases than HIV[ 26 27 ] and even immunocompetent individuals without apparent risk factors. [ 28 ]…”

“…[ 33 34 ] Amphotericin B is often difficult to access and handle in our regions. [ 15 28 ] In a study conducted in Spain in 2000, discharge was favorable for the five patients treated with intravenous amphotericin B associated with flucytosine and fluconazole. [ 33 ] A good therapeutic approach is often difficult to do in our communities for reasons of high cost of care and unavailability of drugs.…”

“…[ 33 ] A good therapeutic approach is often difficult to do in our communities for reasons of high cost of care and unavailability of drugs. [ 5 15 28 35 36 ]…”