title: [Cryptococcal meningitis in patients with diabetes and AIDS].
abstract: BACKGROUND
  Cryptococcal meningitis is a severe AIDS-related infectious disease, with a high mortality rate. Diabetes mellitus (DM) is a metabolic disorder very common worldwide. Infectious diseases in diabetic patients are always more severe than in non-diabetic ones. The aim of this study was to compare the outcome of a group of HIV-positive patients with DM and cryptococcal meningitis with a similar group HIV-positive patients with cryptococcal meningitis, but without DM.
  
  
  METHODS
  A total of 182 clinical records of HIV-positive patients suffering cryptococcal meningitis were reviewed, and 28 of them with similar clinical and epidemiological characteristics, were chosen. They included 14 patients with DM (group A) and the remaining 14 who did not suffer this metabolic disorder (group B).
  
  
  RESULTS
  Only 21.4% (3/14 cases) of group A patients had negative CSF cultures after 10 weeks of treatment. In group B patients, 78.5% (11/14 cases) achieved negative CSF cultures before 10 weeks. A higher overall mortality rate was observed in the diabetic patients (85.7%, 12/14 cases) than in the non-diabetic group (21.4%, 3/14 cases). All CSF isolates were identified as Cryptococcus neoformans, and all strains were susceptible in vitro to amphotericin B and fluconazole.
  
  
  CONCLUSIONS
  Cryptococcal meningitis in diabetic patients was associated with a poor clinical outcome and a high mortality rate. A longer treatment induction period is suggested in order to improve the outcome of cryptococcal meningitis in diabetic patients.
authors.affiliation: Unidad de Micología, Hospital de Infecciosas F J Muñiz, Ciudad Autónoma de Buenos Aires, Argentina. Electronic address: fmessina35@gmail.com.
authors.forename: Fernando Antonio
authors.initials: FA
authors.lastname: Messina
authors.affiliation: Unidad de Micología, Hospital de Infecciosas F J Muñiz, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Negroni
authors.affiliation: Unidad de Micología, Hospital de Infecciosas F J Muñiz, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Elena Isabel
authors.initials: EI
authors.lastname: Maiolo
authors.affiliation: Unidad de Micología, Hospital de Infecciosas F J Muñiz, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Alicia
authors.initials: A
authors.lastname: Arechavala
authors.affiliation: División B HIV-sida, Hospital de Infecciosas F J Muñiz, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Maria Florencia
authors.initials: MF
authors.lastname: Villafañe
authors.affiliation: Unidad de Micología, Hospital de Infecciosas F J Muñiz, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Santiso
authors.affiliation: Unidad de Micología, Hospital de Infecciosas F J Muñiz, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Mario
authors.initials: M
authors.lastname: Bianchi
authors.affiliation: Unidad de Micología, Hospital de Infecciosas F J Muñiz, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Laura
authors.initials: L
authors.lastname: Walker
authors.affiliation: División B HIV-sida, Hospital de Infecciosas F J Muñiz, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Corti
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D048909:Diabetes Complications / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D016919:Meningitis, Cryptococcal / Q000209:etiology*; D012189:Retrospective Studies
keywords: AIDS; Criptococosis meníngea en pacientes diabéticos; Cryptococcal meningitis in diabetic patients; Cryptococcus neoformans; Hepatitis C and cryptococcosis; Hepatitis C y criptococosis; Sida