Clinical Manifestations of Cryptococcal Meningitis in HIV Negative Patients-A Case Study

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DOI: 10.21522/TIJPH.2013.04.02.Art071

Authors : Musanda M. Siyolwe-Woodley


Cryptococcal Meningitis (CM) is a central nervous system infection caused by a fungus. A large majority of cases are caused by Cryptococcus neoformans var. neoformans. The fungus C. neoformans is found in soil that contains bird droppings, particularly pigeon excreta, all over the world. Cryptococcusneoformans var. gatti, on the other hand, is found primarily in tropical and subtropical regions trees, most commonly eucalyptus trees. It grows in the debris around the trees’ bases. Cryptococcal meningitis usually occurs in people who have a compromised immune system and is a rare occurrence in someone who has a normal immune system. Of the two fungi, Cryptococcalgattii is the one more likely to infect someone with a normal immune system.The incidence of infections caused by C.neoformans has risen markedly over the past 20 years as a result of the HIV/AIDS epidemic and increasing use of immunosuppressive therapies. Cryptococcal meningitis is a common opportunistic infection and an AIDS-defining illness in patients with late-stage HIV infection, particularly in Southeast Asia and Southern and East Africa. It is widely considered as the most common life-threatening AIDS related fungal infection. Cryptococcal meningitis has been estimated at about 70 to 90% worldwide in AIDS patients with mortalities of between 50% to 70% in Sub-Saharan Africa. [2,3,4] Mortality from HIV-associated cryptococcal meningitis remains high (13–33%), even in developed countries, because of the inadequacy of current antifungal drugs and combinations, and the complication of raised intracranial pressure.[2,7,8]In the cases presented, the findings were so non-specific that the diagnosis was highly dependent on the CSF findings. Based on the characteristics of the presenting signs and symptoms, Cryptococcal meningitis should always be included in the differential diagnosis of chronic or subacute meningoencephalitis, since clinical features are not specific.


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