Cryptococcal Meningitis of the HIV-Infected Person in Lomé: About 102 Cases over 10 Years

Abstract

Objective: To describe the clinical, epidemiological and evolutionary aspects of cryptococcal meningitis. Methods: This was a retrospective descriptive study on all HIV-infected patients who had been hospitalized for cryptococcal meningitis between 2006 and 2016 in the principal structures for the care of HIV infected person in Lomé. The diagnosis of meningitis was clinical and confirmed by the presence of cryptococci on Chinese ink or the detection of CSFsoluble antigens. All patients have made the CD4 rate assay and received an antifungal treatment based on fluconazole or Amphotericin B, followed later by antiretroviral triple therapy. Results: A total of 102 patients infected with cryptococcal meningitis (62 men for 40 women) were found. The sex ratio was 1.55. The median age was 34 years with extremes of 15 to 49 years. Clinically, headache was the symptomatic symptom in 100% of cases, prone to long runs and weight loss respectively in the proportions of 45% and 65%. The mean CD4 cell count was 65 ± 22 cells per mm 3 . The duration of hospital stay was short (less than 7 days) for the deceased. A total of 62 patients were able to receive treatment, 40 of them with fluconazole and 22 with Amphotericin B. The mortality was very high (65%), 25% were lost to follow-up, and 9.5% still in live 3 months after admission to the hospital. Conclusion: Cryptococcal meningitis has a very reserved prognosis. It is to be feared in cases of severe immunosuppression, hence the early detection of HIV for optimal management is important.

Invasive Fungal Diseases in Africa: A Critical Literature Review

“…This prevalence ranges from 4% to 11.43% with CD4 < 100 cells/mm3 as a common factor [56][57][58][59] and sometimes co-infection with other diseases [56,57]. More data on cryptococcosis are available in Mali, Democratic Republic of Congo (DRC), Togo, Kenya, Ghana, Nigeria, Burkina Faso, Botswana, Senegal, Tanzania, South Africa, Cameroon, and Mozambique, sometimes with a high mortality rate [13,[16][17][18][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75]. Data on cryptococcosis in HIV negative patients and children is rare.…”

Spectrum of central nervous system infections in a tertiary health care centre in Cameroon

“…Immunosuppression is frequently associated to CNS infections. Thus, patients infected with the Human Immunodeficiency Virus (HIV) will be more exposed to these infections [ 18 – 20 ]. Between 2006 and 2016, 102 cases of cryptococcal meningitis were reported in Togo [ 20 ].…”

“…Thus, patients infected with the Human Immunodeficiency Virus (HIV) will be more exposed to these infections [ 18 – 20 ]. Between 2006 and 2016, 102 cases of cryptococcal meningitis were reported in Togo [ 20 ]. In Cameroon, between 2004 and 2009, cerebral toxoplasmosis (32%) and cryptococcal meningitis (25%) were reported as commonest CNS infections in HIV immunocompromised patients [ 19 ].…”