Publication

Abstract : We aimed to 1) estimate the prevalence of cryptococcal infections among clinically suspected cases of chronic meningitis in a tertiary care center, 2) evaluate the clinical, radiological, microbiological features and 3) assess outcome of these patients. Materials and Methods: Medical records of 756 patients investigated for meningitis and any case which was positive for cryptococcus by culture or antigen detection, from January 2006 to December 2012 were abstracted using a standardized abstraction form. The patients’ demographic data, underlying diseases, clinical manifestations, radiological findings, laboratory data, and disease outcomes were retrospectively analyzed. Blood and cerebrospinal fluid specimens were processed by standard microbiological procedures. Results: The proportion of probable cryptococcal meningitis was only 2.4% with male preponderance who were predominantly non-HIV patients. No risk factors could be documented in 16.6% (3/18) cases. India ink was found to be positive in 76.9%, CSF culture in 86.6% (13/15), blood culture in 56.25%, and latex agglutination in 100%. Half the cases were confirmed cryptococcal meningitis while 16.6% had only cryptococcal septicemia. No case of pulmonary and cutaneous cryptococcosis were seen. Conclusion: We underline the need to rule out cryptococcal infection in non-HIV patients and patients with previous history of tuberculosis, as we have documented a higher mortality in this group.