Cryptococcal Meningitis Encountered in Patients with HIV in A Tertiary Care Hospital, Mangalore- A Series of Three Cases
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2015, Vol 3, Issue 8
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. Keywords: AIDS Aquired Immunodeficiency Syndrome, ART Antiretroviral therapy, CD4 CD4 T lymphocyte cell, CDC The Centers for Disease Control and Prevention, CM Cryptococcal meningitis, HIV Human Immunodeficiency Virus, WHO World Health Organization
Authors and Affiliations
Dr. Jutang Babat Ain Tiewsoh, Dr. Beena Antony, Dr. Rekha B
Keywords
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