Prevalence, risk factors and outcome associated with cryptococcal meningitis in HIV positive patients in Algeria: case series and review of literature
BACKGROUND: Cryptococcal meningitis is a severe fungal infection of the central nervous system associated with significant morbidity and mortality among people living with HIV/AIDS (PLWHA). This study aims at determining the prevalence, epidemiological characteristics, clinical features, neuroimagin...
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| Format: | Article |
| Language: | English |
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Verduci Editore
2023-03-01
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| Series: | Infectious Diseases and Tropical Medicine |
| Subjects: | |
| Online Access: | https://www.infectiousjournal.com/wp-content/uploads/sites/6/2023/03/e1093.pdf |
| _version_ | 1797368518540263424 |
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| author | A. Ouyahia M. Rais M. Abdoun A. Kouicem M. Kouicem |
| author_facet | A. Ouyahia M. Rais M. Abdoun A. Kouicem M. Kouicem |
| author_sort | A. Ouyahia |
| collection | DOAJ |
| description | BACKGROUND: Cryptococcal meningitis is a severe fungal infection of the central nervous system associated with significant morbidity and mortality among people living with HIV/AIDS (PLWHA). This study aims at determining the prevalence, epidemiological characteristics, clinical features, neuroimaging, laboratory findings, and treatment, among PLWHA having CM and identifying early predictors of outcome.
CASE PRESENTATION: We retrospectively analyzed data from 11 PLWHA with CM hospitalized in Setif hospital from January 1985 to May 2022. Eight men (72.7%) and three women (27.3%) were involved in the study; the median age was 39.27 years (range: 18-69 years); clinical manifestations included headache (9, 81.8%), fever (7, 63.6%), restless (6, 54.5%), seizure (3, 27.3%), meningeal syndrome (5, 45.5%); CD4 count ≤ 50 cells/mm3 was detected in 6 patients (54.5%), 7 patients (63.6%) showed normal cerebrospinal fluid cell counts and 9 (81.8%) had a normal biochemical examination; 3 patients (27.3%) had abnormalities shown on intracranial imaging; 11 cases (100%) were culture positive, 10 (90.9%) were positive by India ink preparation, and in-hospital mortality was detected in 7 patients (63.6%).
CONCLUSIONS: The study reports a low prevalence of CM among PLWHA attending our hospital and a high mortality despite the administration of Amphotericin b deoxycholate or Fluconazole. Factors as late presentation of patients, the lack of CrAg screening and the absence of Flucytosine may have contributed to the poor outcome. |
| first_indexed | 2024-03-08T17:33:38Z |
| format | Article |
| id | doaj.art-61c103a54be64b92a3fd4ad756a0af80 |
| institution | Directory Open Access Journal |
| issn | 2379-4054 |
| language | English |
| last_indexed | 2024-03-08T17:33:38Z |
| publishDate | 2023-03-01 |
| publisher | Verduci Editore |
| record_format | Article |
| series | Infectious Diseases and Tropical Medicine |
| spelling | doaj.art-61c103a54be64b92a3fd4ad756a0af802024-01-02T13:27:41ZengVerduci EditoreInfectious Diseases and Tropical Medicine2379-40542023-03-01910.32113/idtm_20233_10931093Prevalence, risk factors and outcome associated with cryptococcal meningitis in HIV positive patients in Algeria: case series and review of literatureA. Ouyahia0M. Rais1M. Abdoun2A. Kouicem3M. Kouicem4Department of Infectious Diseases, Faculty of Medicine, University Ferhat Abbas Setif 1, Setif, AlgeriaDepartment of Infectious Diseases, Faculty of Medicine, University Ferhat Abbas Setif 1, Setif, AlgeriaDepartment of Epidemiology, Faculty of Medicine, University Ferhat Abbas Setif 1, Setif, AlgeriaDepartment of Gynecology and Obstetrics, Faculty of Medicine, University Ferhat Abbas Setif 1, Setif, AlgeriaDepartment of Biotechnology and Health, École Nationale Supérieure de Biotechnologie, Constantine, AlgeriaBACKGROUND: Cryptococcal meningitis is a severe fungal infection of the central nervous system associated with significant morbidity and mortality among people living with HIV/AIDS (PLWHA). This study aims at determining the prevalence, epidemiological characteristics, clinical features, neuroimaging, laboratory findings, and treatment, among PLWHA having CM and identifying early predictors of outcome. CASE PRESENTATION: We retrospectively analyzed data from 11 PLWHA with CM hospitalized in Setif hospital from January 1985 to May 2022. Eight men (72.7%) and three women (27.3%) were involved in the study; the median age was 39.27 years (range: 18-69 years); clinical manifestations included headache (9, 81.8%), fever (7, 63.6%), restless (6, 54.5%), seizure (3, 27.3%), meningeal syndrome (5, 45.5%); CD4 count ≤ 50 cells/mm3 was detected in 6 patients (54.5%), 7 patients (63.6%) showed normal cerebrospinal fluid cell counts and 9 (81.8%) had a normal biochemical examination; 3 patients (27.3%) had abnormalities shown on intracranial imaging; 11 cases (100%) were culture positive, 10 (90.9%) were positive by India ink preparation, and in-hospital mortality was detected in 7 patients (63.6%). CONCLUSIONS: The study reports a low prevalence of CM among PLWHA attending our hospital and a high mortality despite the administration of Amphotericin b deoxycholate or Fluconazole. Factors as late presentation of patients, the lack of CrAg screening and the absence of Flucytosine may have contributed to the poor outcome.https://www.infectiousjournal.com/wp-content/uploads/sites/6/2023/03/e1093.pdfcryptococcal meningitisaidsoutcomemortalityprognosis |
| spellingShingle | A. Ouyahia M. Rais M. Abdoun A. Kouicem M. Kouicem Prevalence, risk factors and outcome associated with cryptococcal meningitis in HIV positive patients in Algeria: case series and review of literature Infectious Diseases and Tropical Medicine cryptococcal meningitis aids outcome mortality prognosis |
| title | Prevalence, risk factors and outcome associated with cryptococcal meningitis in HIV positive patients in Algeria: case series and review of literature |
| title_full | Prevalence, risk factors and outcome associated with cryptococcal meningitis in HIV positive patients in Algeria: case series and review of literature |
| title_fullStr | Prevalence, risk factors and outcome associated with cryptococcal meningitis in HIV positive patients in Algeria: case series and review of literature |
| title_full_unstemmed | Prevalence, risk factors and outcome associated with cryptococcal meningitis in HIV positive patients in Algeria: case series and review of literature |
| title_short | Prevalence, risk factors and outcome associated with cryptococcal meningitis in HIV positive patients in Algeria: case series and review of literature |
| title_sort | prevalence risk factors and outcome associated with cryptococcal meningitis in hiv positive patients in algeria case series and review of literature |
| topic | cryptococcal meningitis aids outcome mortality prognosis |
| url | https://www.infectiousjournal.com/wp-content/uploads/sites/6/2023/03/e1093.pdf |
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