[Cryptococcal meningitis and AIDS. Clinical description of 10 patients].
We have studied 10 patients with cryptococcal meningitis and AIDS. Nine of them were intravenous drug users and four have been previously diagnosed of AIDS. In 60% of them cryptococcal meningitis was the first opportunistic infection, and as group represented only 6.3% of our 158 patients with AIDS on the same period. The most common symptoms were: malaise (100%), headache (80%), fever (60%), meningeal signs (50%). Two of them had focal neurological disease. CSF culture and serum cryptococcal antigen test were positive in 90%, the Indian ink in 77% and blood cultures in 30% of the cases, while indian ink preparation did it in 77%. MRI showed bilateral small lesions, deeply located, in 3 cases; it was also useful to prove optical tract lesions in a patient with blindness as a result of cryptococcal meningitis. We had treatment successes in 80% of the cases, all patients being treated with amphotericin B, alone in 4 and amphotericin B plus fluorocytosine in 6. Two patients died within the first 2 weeks. Maintenance therapy with fluconazole was effective and well tolerated, with 3 patients dying from causes other than cryptococcal meningitis. We recorded a survival rate over 12 months in 33% of patients.
Aguirrebengoa
L
L
Servicio de Medicina Interna, Universidad del País Vasco, Hospital de Cruces, Baracaldo, Vizcaya.
Montejo
M
M
Prieta
R
R
Uterga
J
J
Gaztelurrutia
L
L
Arce
M D
MD
Aguirre
C
C
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D000946:Antigens, Fungal / Q000032:analysis; D003455:Cryptococcus neoformans / Q000276:immunology / Q000302:isolation & purification; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D016919:Meningitis, Cryptococcal / Q000134:cerebrospinal fluid / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D009894:Opportunistic Infections / Q000134:cerebrospinal fluid / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D012008:Recurrence
D000935:Antifungal Agents; D000946:Antigens, Fungal
Meningitis criptocócica y SIDA. Descripción clínica de 10 pacientes.