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Characteristics and outcome of 48 consecutive cryptococcal meningitis in HIV patients.
Mallolas J; Aznar E; Miro JM; Zamora L; Gatell JM; Soriano E; Infectious
November 30, 1993
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