Cryptococcal meningitis in HIV (AIDS) patients: A Mini Review

Abstract

Meningitis is a major health problem causing inflammation of the protective membranes covering the brain and spinal cord, collectively known as the meninges. Meningitis is generally caused by Meningococcus, Streptococcus pyogenes bacterial species causing bacterial meningitis: BM), Mycobacterium tuberculosis (Tubercular meningitis: TBM), Cryptococcus neoformans (fungal meningitis: CM). In recent times the CM and TBM are two most common types of chronic infectious meningitis. In adults, HIV-associated Cryptococcal meningitis has been reported in many areas of the world having high HIV seroprevalence i.e. in Sub-Saharan Africa. Cryptococcal meningitis is the fourth most commonly recognized cause of life-threatening infection among AIDS patients.Despite availability of antiretroviral therapy, the rise in rate of infections due to HIV/AIDS, suppress the cell mediated immune system and subjects are predisposed for opportunistic infections. Additionally, In AIDS patients, it is characterized by lack of meningeal signs and diminished inflammatory response. Diagnosis of CM is generally based on the collection of CSF sample and/or blood samples. Initially the CSF samples are processed for 'gold standard' culture methods, microscopy and India ink preparation. Serologically, Latex agglutination test (LAT) is the most commonly used for detection of Cryptococcal capsular antigen. Enzyme immunoassay (EIA) is another serological tool for detection of capsular polysaccharide antigens of C. neoformans in CSF.