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Cryptococcal meningitis in HIV infected: experience from a North Indian tertiary center.

Abstract：

BACKGROUND:Cryptococcal meningitis is a common opportunistic infection in Human Immunodeficiency Virus (HIV)-infected individuals. There is little information specifically addressing cryptococcal meningitis in HIV-infected patients from North India. AIMS:To determine clinical presentation, hospital course, response to treatment, complications developed, in-hospital mortality, any recurrence of cryptococcal meningitis and reasons of recurrence during follow-up. SETTINGS AND DESIGN:A retrospective observational study undertaken in a large tertiary care center. PATIENTS AND METHODS:Patient's demographic data, presenting clinical symptomatology, physical findings, laboratory parameters, cerebrospinal fluid (CSF) examination findings, side-effects of treatment, development of any complications and hospital outcome were analyzed. During follow-up any recurrence of cryptococcal meningitis, possible reasons of recurrence, type of treatment received, complications developed and outcome was recorded as well. RESULTS:Forty patients diagnosed to have cryptococcal meningitis were analyzed. Twenty-two (55%) patients had acute/ subacute presentation. Thirty-six (90%) patients presented with headache and 18 (45%) had altered sensorium. Twenty (50%) patients had no cells in the CSF. Hypoglycorrhchia was seen in 30 (75%) patients. Cryptococcal meningitis was the first acquired immune deficiency syndrome (AIDS)-defining illness in 30 (75%) patients. Thirty-five patients developed some adverse effects to amphotericin-B. Thirty-three patients improved with treatment while three patients died. Four patients had recurrence of cryptococcal meningitis within six months of first episode. Non-compliance of fluconazole therapy was the reason for recurrence in all of these patients. CONCLUSIONS:Cryptococcal meningitis is a common initial AIDS-defining illness. Acute and/or subacute presentation of cryptococcal meningitis is not uncommon in HIV-infected individuals. An early diagnosis of HIV infection might reduce the incidence of this infection.

journal_name

Neurol India

journal_title

Neurology India

authors

Kumar S,Wanchu A,Chakrabarti A,Sharma A,Bambery P,Singh S

subject

Has Abstract

pub_date

2008-10-01 00:00:00

pages

444-9

issue

eissn

0028-3886

issn

1998-4022

journal_volume

pub_type

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Cryptococcal meningitis in HIV infected: experience from a North Indian tertiary center.