Hospital-based retrospective study of cryptococcal meningitis in a large cohort from India

Cryptococcal meningitis commonly affects immunocompromised cases and can have varied presentation. In some instances, the presence of a plethora of inflammatory cells on cerebrospinal fluid (CSF) in an immunosuppressed patient can lead to further investigations, which unravel the presence of cryptococcal meningitis. The aim of this retrospective study was to analyze the spectrum of CSF findings of immunosuppressed patients who were diagnosed to have cryptococcal meningitis. Retrospective analysis of CSF cytospin slides exhibiting pleocytosis and belonging to immunocompromised patients was performed, and these cases were found to have cryptococcal meningitis. Out of 932 cases of CSF (January 2016‐July 2017), 10 had pleocytosis and 5 of these 10 cases demonstrated spores of Cryptococcus. Male‐to‐female ratio was 1:1.5. All the patients were immunocompromised and had CSF leukocytosis. Lymphocytes and monocytes were present in all samples while only one case showed plasma cells. Spores of Cryptococcus were also noted in all the cases and highlighted on India Ink Preparation and Gomori Methenamine Silver stain. All the cases were positive for agglutination‐based cryptococcal antigen assay, except one where the test was not done. All immunosuppressed patients having pleocytosis in CSF were found to have cryptococcal infection. Therefore, pleocytosis in CSF in any immunosuppressed patient should raise the suspicion of cryptococcal meningitis. The pathologist and the clinician need to be vigilant in such scenarios to rule out any opportunistic infection and investigate the patient thoroughly for any underlying immunosuppression.

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Cerebrospinal fluid pleocytosis in immunocompromised patients: Can it be Cryptococcus

Sood

Tyagi

Selhi

et al. 2019

Diagnostic Cytopathology

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Cryptococcal meningitis presenting as acute flaccid paralysis: A case report

Forero

Pinilla-Monsalve

Valderrama-Chaparro

et al. 2020

Journal of Infection and Public Health

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The prognostic factors of HIV-negative adult cryptococcal meningitis with a focus on cranial MRI-based neuroimaging findings

Tsai

Lien

Lee

et al. 2018

Journal of Clinical Neuroscience

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Hospital-based retrospective study of cryptococcal meningitis in a large cohort from India

Cited by 10 publications

References 16 publications

Cerebrospinal fluid pleocytosis in immunocompromised patients: Can it be Cryptococcus

Cerebrospinal fluid pleocytosis in immunocompromised patients: Can it be Cryptococcus

Cryptococcal meningitis presenting as acute flaccid paralysis: A case report

The prognostic factors of HIV-negative adult cryptococcal meningitis with a focus on cranial MRI-based neuroimaging findings

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