Cryptococcal infections of the central nervous system: an analysis of predisposing factors, laboratory findings and outcome in patients from South India with special reference to HIV infection Free

Abstract

The incidence of cryptococcosis in patients with AIDS is significant. Predisposing factors, laboratory findings and outcome were assessed in 60 patients with cryptococcal infections of the central nervous system over a 17.5-year period (Jan. 1978-June 1995). Predisposing factors for cryptococcal infection were identified in 36 patients, with HIV infection being the commonest (18). Cryptococcal cultures were positive in all patients. India ink staining was positive in 48 patients and cryptococcal antigen was detected in 35 of 36 patients tested. Comparison of clinical and laboratory parameters between HIV-positive and HIV-negative patients showed that CSF cell response was poorer, culture of cryptococci from non-neural sites was more frequent and mortality was higher in the HIV-positive group. Although not statistically significant, concurrent systemic infections, especially tuberculosis, were more frequent in the HIV-positive group.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/00222615-45-5-376
1996-11-01
2024-03-29
Loading full text...

Full text loading...

/deliver/fulltext/jmm/45/5/medmicro-45-5-376.html?itemId=/content/journal/jmm/10.1099/00222615-45-5-376&mimeType=html&fmt=ahah

References

  1. Dismukes W. E. Cryptococcal meningitis in patients with AIDS. J Infect Dis 1988; 157:624–628
    [Google Scholar]
  2. Chuck S. L., Sande M. A. Infections with Cryptococcus neoformans in the acquired immunodeficiency syndrome. N Engl J Med 1989; 321:794–799
    [Google Scholar]
  3. Kozel T. R. Virulence factors of Cryptococcus neoformans. Trends Microbiol 1995; 3:295–299
    [Google Scholar]
  4. Training module on the sentinel surveillance of HIV infection National AIDS Control Organisation, Ministry of Health and Family Welfare, Govt of India. June 1993
  5. Gourie-Devi M., Satishchandra P. Hyaluronidase as an adjuvant in the management of tuberculous spinal arachnoiditis. J Neurol Sci 1991; 102:105–111
    [Google Scholar]
  6. Yu Y. L., Lau Y. N., Woo E., Wong K. L., Tse B. Cryptococcal infection of the nervous system. Q J Med 1988; 66:87–96
    [Google Scholar]
  7. Kaufman L., Blumer S. Value and interpretation of serological tests for the diagnosis of cryptococcosis. Appl Microbiol 1968; 16:1907–1912
    [Google Scholar]
  8. Goodman J. S., Kaufman L., Koenig M. G. Diagnosis of cryptococcal meningitis. Value of immunological detection of cryptococcal antigen. N Engl J Med 1971; 285:434–436
    [Google Scholar]
  9. Currie B. P., Freundlich L. F., Soto M. A., Casadevall A. False-negative cerebrospinal fluid cryptococcal latex agglutination tests for patients with culture-positive cryptococcal meningitis. J Clin Microbiol 1993; 31:2519–2522
    [Google Scholar]
  10. Perfect J. R. Cryptococcosis. Infect Dis Clin North Am 1989; 3:77–102
    [Google Scholar]
  11. Mitchell T. G., Perfect J. R. Cryptococcosis in the era of AIDS – 100 years after the discovery of Cryptococcus neoformans. Clin Microbiol Rev 1995; 8:515–548
    [Google Scholar]
  12. Kwon-Chung K. J., Bennett J. E. Epidemiologic differences between the two varieties of Cryptococcus neoformans. Am J Epidemiol 1984; 120:123–130
    [Google Scholar]
  13. Clark R. A., Greer D., Atkinson W., Valainis G. T., Hyslop N. Spectrum of Cryptococcus neoformans infection in 68 patients infected with human immunodeficiency virus. Rev Infect Dis 1990; 12:768–777
    [Google Scholar]
  14. Kaur A., Babu P. G., Jacob M. Clinical and laboratory profile of AIDS in India. J Acquir Immune Defic Syndr 1992; 5:883–889
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/00222615-45-5-376
Loading
/content/journal/jmm/10.1099/00222615-45-5-376
Loading

Data & Media loading...

Most cited Most Cited RSS feed