title: Prognostic markers in AIDS-related cryptococcal meningitis.
abstract: OBJECTIVE
  Despite the advent and expanding access to antiretroviral therapy, HIV-associated cryptococcal meningitis (CM) remains a significant cause of mortality and morbidity amongst individuals with this infection in resource-limited settings.
  
  
  METHODS
  We prospectively studied the clinical, biochemical and mycological parameters of 30 HIV patients diagnosed with cryptococcal meningitis at our centre over a period of 6 months with a view to identify prognostic factors predictive of poor outcome.
  
  
  RESULTS
  Our study documented a mortality rate of 36.7%. Age, sex and previous diagnosis of HIV had no bearing on the survival outcome of patients. The study identified several poor prognostic factors including low GCS score, papilledema, elevated CSF opening pressure (>250 mm of H2O) and lack of regular HIV care in those with a prior diagnosis of HIV. CSF pleocytosis was significantly higher in the mortality group.
  
  
  CONCLUSIONS
  There have been relatively few attempts to focus on poor prognostic markers associated with AIDS related Cryptococcal meningitis in Asian patients. Our study highlights how simple bedside clinical tools like ophthalmoscopy and CSF manometry can help in risk stratification in this group of patients.
authors.affiliation: Apollo Gleneagles Hospital, Kolkata, West Bengal.
authors.forename: S
authors.initials: S
authors.lastname: Majumder
authors.forename: S K
authors.initials: SK
authors.lastname: Mandal
authors.forename: D
authors.initials: D
authors.lastname: Bandyopadhyay
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D000328:Adult; D017677:Age Distribution; D000935:Antifungal Agents / Q000627:therapeutic use; D015415:Biomarkers; D003455:Cryptococcus neoformans / Q000302:isolation & purification; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D016919:Meningitis, Cryptococcal / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D017678:Sex Distribution; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D015415:Biomarkers