RESUMEN
The ceredrospinal fluid of patients with AIDS and Cryptococcus neoformans infection (n = 62) and those of non-AIDS with Cryptococcus neoformans infection (n = 31) were analysed for white cell count, protein and CSF sugar/blood sugar levels. The mean value of white cell count (39.43/cumm VS 160.83/cumm) and protein (77.91 mg/dl Vs 118.2 mg/dl) in patient with AIDS and cryptococcal infection were statistically significant lower than non-AIDS patients with cryptococcal infection (p < 0.005 and p < 0.01), whereas there were no difference in CSF sugar/levels. Two-thirds of the patients with AIDS and cryptococcal infection had the white cell count less than 10 cell/cumm. These data shows that AIDS aptients have lower immune response to cryptococcus neoformans than non-AIDS patients. Thus it is advisable that Indian ink preparation of CSF is always necessary for AIDS patients in spite of normal white cell count in the CSF.
RESUMEN
The first Binswanger’s Disease in Thailand was documented. He was a 87 year old doctor having the trouble of tremor, difficulty in walking, memory loss and behavioural change for 1 year. He had been suffering from hypertension and ischaemic heart disease for 4 years. Recently his relative noticed that he had needed regular attendant to cope with his normal daily living. He could not control his bladder and bowel openings as well as confusion at night time with some hallucination. Examination revealed sthenic build, alert, but marked memory deficit. He could not calculate the simple subtraction of seven from 100, proverb interpretation, and abstract thinking in spite of his clear understanding and no speech trouble. Neurological examination showed generalized rigidity of muscle and hand tremor. Deep tendon reflexes were exaggerated with bilateral Babinski signs. Computed brain scan revealed diffuse brain atrophy with periventricular and centrum semiovale low density areas. The ventricles were enlarged as well as widened sulci. The patient was admitted for 18 days with symptomatic treatment. The up to date literature on Binswanger’s disease is reviewed in this report.