Int Conf AIDS. 1993 Jun 6-11;9(1):367 (abstract no. PO-B09-1393). Unique
We describe the characteristics and the outcome in 48 consecutive
Cryptococcal meningitis in HIV patients. The diagnosis of Cryptococcal
meningitis was accepted if a latex agglutination test for cryptococcal
antigen in cerebrospinal fluid was positive with or without a
concomitant culture or India ink stain positive. From June-1987 to
December-1992 we have diagnosed 48 consecutive Cryptococcal meningitis
in HIV patients among a total number of about 1000 AIDS cases (4.8%).
The mean age was 32.8 years (range: 22-49), 40 (83.3%) were males and
the behavioral risk for HIV was: Intravenous drug abuser 26 (54%),
homosexual male 14 (29%), heterosexual contact 7 (14.5%) and haemophilia
1 2%). At diagnosis, the mean CD4 cell count per mililiter was 110
range: 1-200). In 20 cases Cryptococcal meningitis was the first AIDS
indicator and in 28 cases appeared after another opportunistic
infection. Amphotericin B therapy was the main therapeutical approach in
the acute phase. We could follow 14 patients after the recovery and 10
received fluconazole 200 mg/day po and 3 of them developed a relapse
(30%) in a median follow-up of 12 months while in the remaining 4 cases,
3 relapsed 75%). Until December-1992, 32 (66%) of the 48 patients have
already died. Although Cryptococcal meningitis is a relatively
infrequent manifestation in our HIV patients, it is a severe condition
with a high mortality and maintenance therapy with fluconazole is useful
to avoid relapses.
*Amphotericin B/THERAPEUTIC USE *AIDS-Related Opportunistic
Infections/DRUG THERAPY *Fluconazole/THERAPEUTIC USE *Meningitis,
Cryptococcal/DRUG THERAPY