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Characteristics and outcome of 48 consecutive cryptococcal meningitis in HIV patients.


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


Information in this article was accurate in November 30, 1993. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.