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Scholars Journal of Applied Medical Sciences | Volume-3 | Issue-08
Cryptococcal Meningitis Encountered in Patients with HIV in A Tertiary Care Hospital, Mangalore- A Series of Three Cases
Dr. Jutang Babat Ain Tiewsoh, Dr. Beena Antony, Dr. Rekha B
Published: Nov. 26, 2015 |
112
94
DOI: 10.36347/sjams.2015.v03i08.028
Pages: 2879-2885
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Abstract
Cryptococcus neoformans is an encapsulated yeast which can infect the central nervous system due to its
ability to synthesise melanin from catecholamines. Cryptococcal meningitis is a common opportunistic infection in HIV
infected individuals and an AIDS defining illness. Mortality rate is high, if treatment is delayed. This prospective
observational study in a tertiary care hospital, during August 2013 to June 2015 includes patient’s demographic data,
clinical symptoms, physical findings, laboratory parameters; Cerebrospinal fluid examination findings, other
opportunistic infection, co-infections, treatment, hospital stay and outcome were recorded. Three cases presented with
Cryptococcal meningitis. They were all males between 35-50 years of age, married and known cases of HIV with two
cases on ART. Headache and vomiting were the common presenting symptoms in Cryptococcus meningitis was
diagnosed by india ink wet mount, Cryptococcal antigen test and by culture. Two of the cases had other opportunistic
infection with low CD4 count. Two patients improved on treatment with Amphotericin B while the other left against
medical advice. HIV infected individuals presenting with meningitis symptoms should be suspected for Cryptococcal
meningitis. In addition to india ink preparation, Cryptococcal Antigen test should also be included as part of the
diagnostic schedule. Low CD4 count was observed in Cryptococcal meningitis but early diagnosis and treatment shows
good outcome.