Prevalence of central nervous system cryptococcosis in human immunodeficiency virus reactive hospitalized patients

Abstract

Central nervous system cryptococcosis is an important cause of mortality among human immunodeficiency virus (HIV) reactive patients. A retrospective study was conducted on a total of 1,863 HIV reactive hospitalized patients suspected of cryptococcal meningitis. Three hundred and fifty-nine cerebrospinal fluid specimens of these cases were screened for various cryptococcal investigations. Thirty-nine out of 359 (10.86%) showed a definite diagnosis of cryptococcosis with a mortality rate of 25.64%. Prevalence of cryptococcal meningitis in the total HIV reactive cohort was 2.09%. Concurrent cryptococcal meningitis and tuberculosis was seen in 33.3% cases. A high index of clinical suspicion and routine mycological surveillance is required to help an early diagnosis and appropriate therapy, as majority of patients respond well to therapy if treated early.

Central Nervous System Cryptococcosis among a Cohort of HIV Infected Patients from a University Hospital of North India

“…The incidence rate in our study was 12.9%, which was comparable to the findings of other north Indian studies [14] but it differed from the reports from south India [13,15,16] and other parts of the world [17,18]. The age range of the patients in our study population was very diverse ( 19-60 years) and there was a male predominance.…”

In vitro antifungal susceptibility profiles and genotypes of 308 clinical and environmental isolates of Cryptococcus neoformans var. grubii and Cryptococcus gattii serotype B from north-western India

“…Cryptococcosis is a life-threatening, opportunistic fungal infection of worldwide distribution, including India, especially in the human immunodeficiency virus (HIV) positive population (Casadevall & Perfect, 1998;Chakrabarti et al, 2000;Khanna et al, 2000;Lakshmi et al, 2007;Thakur et al, 2008). It has two major aetiological agents, namely Cryptococcus neoformans and Cryptococcus gattii.…”

A 28 Years Old Woman with Severe Headache and Few Episodes of Vomiting: A Case Report

“…Patients with chronic headache and fatigue should be screened for possible aseptic meningitis and detection of fungal infections may improve in patients (whether immunocompetent or immunocompromised) suspected of meningitis if CSF fluid was sent for Indian Ink stain besides gram stain. A study has shown that immunosuppressed patients present with less typical clinical symptoms of meningitis (Lakshmi et al, 2007). Our patient presented with sinusitis and headache.…”

“…Clues to the diagnosis in this case included an atypical headache (sub acute), high grade fever and new onset seizures. Computed tomography of the brain is normal in 50% of proven cases; however, a focal neurological exam and abnormalities on brain CT or MRI have both been linked to a poorer prognosis (Lakshmi et al, 2007) but this patient had no focal lesions except for mild cortical edema. The CSF WBC count is typically low (<50 microL ) with a lymphocytic predominance (53%), which was favorable for aseptic meningitis and normal gram stain of CSF suggested a probability of TB meningitis and normal Zeehl Neilsen staining for TB, indicated for Indian ink staining which was positive for yeast cells.…”