Cryptococcal meningitis: An under-reported disease from the hills of Uttarakhand: A hospital-based cross-sectional study
Background: Cryptococcal meningitis is a fatal opportunistic neuroinfection and an AIDS defining illness. It can also occur in non-HIV patients who are immunodefecient due to chronic glucocorticoid use, organ transplantation, malignancy and sarcodiosis. Materials and Methods: A cross-sectional study...
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| Format: | Article |
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Wolters Kluwer Medknow Publications
2019-01-01
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| Series: | Journal of Family Medicine and Primary Care |
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| Online Access: | http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=6;spage=2008;epage=2011;aulast=Mohanty |
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| author | Aroop Mohanty Mohit Bhatia Ankita Kabi Kuhu Chatterjee Neelam Kaistha Balram Ji Omar Puneet K Gupta Pratima Gupta |
| author_facet | Aroop Mohanty Mohit Bhatia Ankita Kabi Kuhu Chatterjee Neelam Kaistha Balram Ji Omar Puneet K Gupta Pratima Gupta |
| author_sort | Aroop Mohanty |
| collection | DOAJ |
| description | Background: Cryptococcal meningitis is a fatal opportunistic neuroinfection and an AIDS defining illness. It can also occur in non-HIV patients who are immunodefecient due to chronic glucocorticoid use, organ transplantation, malignancy and sarcodiosis. Materials and Methods: A cross-sectional study was conducted in a tertiary care hospital from July to December 2018. CSF samples of 364 patients were received by Microbiology laboratory during this period for the purpose of aerobic bacterial, fungal and TB culture, respectively. All samples were subjected to examination by direct wet mount, Gram stain and India ink preparation. Ziehl Neelsen staining, solid culture for Mycobacterium tuberculosis on Lowenstein Jensen medium and Gene Xpert was also performed on all CSF samples. These samples were further subjected to fungal culture on Sabouraud's dextrose agar. Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry (MALDI-TOF-MS) was used for identifying all bacterial (except M. tuberculosis) and fungal isolates. Results: Out of 364 CSF samples received, 288 were sterile after 48 hours of aerobic incubation. Bacterial isolates, M. tuberculosis and Cryptococcus spp. were obtained in culture from 51, 21 and 4 samples, respectively. The prevalence of cryptococcal meningitis in our study was 1.09% (4/364). Cryptococcus neoformans var grubii was the most common isolate (2/4; 50%) followed by Cryptococcus neoformans var neoformans (1/4; 25%) and Cryptococcus neoformans var gattii (1/4; 25%), respectively. Conclusion: Cryptococcal meningitis is a rapidly fatal condition which requires a high index of suspicion and calls for a collective effort from family physicians and diagnosticians alike. This disease is under-reported from Uttarakhand and therefore calls for further research from this region. |
| first_indexed | 2024-12-20T11:22:07Z |
| format | Article |
| id | doaj.art-7c7a988fb47b4d5abbafacce3e5a5b0e |
| institution | Directory Open Access Journal |
| issn | 2249-4863 |
| language | English |
| last_indexed | 2024-12-20T11:22:07Z |
| publishDate | 2019-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Family Medicine and Primary Care |
| spelling | doaj.art-7c7a988fb47b4d5abbafacce3e5a5b0e2022-12-21T19:42:29ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632019-01-01862008201110.4103/jfmpc.jfmpc_216_19Cryptococcal meningitis: An under-reported disease from the hills of Uttarakhand: A hospital-based cross-sectional studyAroop MohantyMohit BhatiaAnkita KabiKuhu ChatterjeeNeelam KaisthaBalram Ji OmarPuneet K GuptaPratima GuptaBackground: Cryptococcal meningitis is a fatal opportunistic neuroinfection and an AIDS defining illness. It can also occur in non-HIV patients who are immunodefecient due to chronic glucocorticoid use, organ transplantation, malignancy and sarcodiosis. Materials and Methods: A cross-sectional study was conducted in a tertiary care hospital from July to December 2018. CSF samples of 364 patients were received by Microbiology laboratory during this period for the purpose of aerobic bacterial, fungal and TB culture, respectively. All samples were subjected to examination by direct wet mount, Gram stain and India ink preparation. Ziehl Neelsen staining, solid culture for Mycobacterium tuberculosis on Lowenstein Jensen medium and Gene Xpert was also performed on all CSF samples. These samples were further subjected to fungal culture on Sabouraud's dextrose agar. Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry (MALDI-TOF-MS) was used for identifying all bacterial (except M. tuberculosis) and fungal isolates. Results: Out of 364 CSF samples received, 288 were sterile after 48 hours of aerobic incubation. Bacterial isolates, M. tuberculosis and Cryptococcus spp. were obtained in culture from 51, 21 and 4 samples, respectively. The prevalence of cryptococcal meningitis in our study was 1.09% (4/364). Cryptococcus neoformans var grubii was the most common isolate (2/4; 50%) followed by Cryptococcus neoformans var neoformans (1/4; 25%) and Cryptococcus neoformans var gattii (1/4; 25%), respectively. Conclusion: Cryptococcal meningitis is a rapidly fatal condition which requires a high index of suspicion and calls for a collective effort from family physicians and diagnosticians alike. This disease is under-reported from Uttarakhand and therefore calls for further research from this region.http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=6;spage=2008;epage=2011;aulast=MohantyAmphotericin Bcryptococcal meningitisMALDI-TOF |
| spellingShingle | Aroop Mohanty Mohit Bhatia Ankita Kabi Kuhu Chatterjee Neelam Kaistha Balram Ji Omar Puneet K Gupta Pratima Gupta Cryptococcal meningitis: An under-reported disease from the hills of Uttarakhand: A hospital-based cross-sectional study Journal of Family Medicine and Primary Care Amphotericin B cryptococcal meningitis MALDI-TOF |
| title | Cryptococcal meningitis: An under-reported disease from the hills of Uttarakhand: A hospital-based cross-sectional study |
| title_full | Cryptococcal meningitis: An under-reported disease from the hills of Uttarakhand: A hospital-based cross-sectional study |
| title_fullStr | Cryptococcal meningitis: An under-reported disease from the hills of Uttarakhand: A hospital-based cross-sectional study |
| title_full_unstemmed | Cryptococcal meningitis: An under-reported disease from the hills of Uttarakhand: A hospital-based cross-sectional study |
| title_short | Cryptococcal meningitis: An under-reported disease from the hills of Uttarakhand: A hospital-based cross-sectional study |
| title_sort | cryptococcal meningitis an under reported disease from the hills of uttarakhand a hospital based cross sectional study |
| topic | Amphotericin B cryptococcal meningitis MALDI-TOF |
| url | http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=6;spage=2008;epage=2011;aulast=Mohanty |
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