Cryptococcal meningitis in HIV infected: experience from a North Indian tertiary center.
Neurol India
;
2008 Oct-Dec; 56(4): 444-9
Article
in English
| IMSEAR
| ID: sea-121466
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 ANDDESIGN:
A retrospective observational study undertaken in a large tertiary care center. PATIENTS ANDMETHODS:
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.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Female
/
Humans
/
Male
/
HIV Infections
/
Retrospective Studies
/
Meningitis, Cryptococcal
/
AIDS-Related Opportunistic Infections
/
Adult
/
India
/
Middle Aged
Type of study:
Observational study
/
Prognostic study
/
Screening study
Country/Region as subject:
Asia
Language:
English
Journal:
Neurol India
Year:
2008
Type:
Article
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