Central Nervous System Cryptococcosis among a Cohort of HIV Infected Patients from a University Hospital of North India 1385-1387
Dr. Chaitanya Nigam
Service Senior Resident, Department of Microbiology
Institute of Medical Sciences, Banaras Hindu University
Varanasi- 221005 India.
Phone: +91 â€“ 9236606095
Background: Cryptococcus neoformans is a ubiquitous encapÂsulated yeast that causes significant infections which range from asymptomatic pulmonary colonization to the life threatening meningoencephalitis, especially in immunocompromised indiÂviduals. Cryptococcal meningitis is one of the AIDS-defining illnesses. Recent data have indicated that, the incidence of the cryptococcal infection is high in developing countries like India. We conducted this study to find out the incidence of cryptococcosis in this area.
Material and Methods: The Cerebrospinal Fluid (CSF) specimens were collected from known HIV positive cases that had a clinical diagnosis of meningitis and they were processed by standard microbiological procedures. The cryptococcal isolates were identified by microscopy, their cultural characteristics, sugar assimilation and by the hydrolysis of urea.
Results: The incidence of cryptococcal meningitis was 12.9%. All the strains were susceptible to amphotericin B, fluconazole, itraconazole and voriconazole.
Conclusion: The cryptococcal infection should be suspected in all cases of meningitis, especially among HIV infected persons. An early diagnosis and treatment may alter the prognosis of these patients and hence, an examination of the CSF for cryptococcosis should be considered in all the HIV infected persons who have the symptoms of meningitis.