Cryptococcal Meningitis in HIV Patients from a Tertiary Care Centre in Northern India
Introduction: Cryptococcal meningitis, caused by Cryptococcus neoformans, an opportunistic fungal infection that affects immunocompromised Human Immunodeficiency Virus (HIV)/ Acquired Immunodeficiency Syndrome (AIDS) patients. In recent years, the incidence of cryptococcal meningitis has increas...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Pvt. Ltd.
2019-10-01
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| Series: | National Journal of Laboratory Medicine |
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| Online Access: | http://www.njlm.net/articles/PDF/2361/41492_CE[Ra1]_F(SHU)_PF1(AG_SHU)_PFA(KM)_PB(AG_SHU)_PN(SHU).pdf |
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| author | Shiwangi Sharma Arvind Achra Renu Kumari Anuradha Nandini Duggal |
| author_facet | Shiwangi Sharma Arvind Achra Renu Kumari Anuradha Nandini Duggal |
| author_sort | Shiwangi Sharma |
| collection | DOAJ |
| description | Introduction: Cryptococcal meningitis, caused by Cryptococcus
neoformans, an opportunistic fungal infection that affects
immunocompromised Human Immunodeficiency Virus (HIV)/
Acquired Immunodeficiency Syndrome (AIDS) patients. In recent
years, the incidence of cryptococcal meningitis has increased in
both the HIV-positive and HIV-negative patients; therefore there
is a need for development of efficient methods for early diagnosis
and treatment to reduce mortality and morbidity.
Aim: To determine the incidence of cryptococcal meningitis
in HIV/AIDS patients and to compare the results of latex
agglutination test and India ink preparation with fungal culture
examination.
Materials and Methods: A total of 204 Cerebrospinal fluid
(CSF) samples from HIV-positive patients (aged >18 years)
showing signs and symptoms of meningitis were collected. The
samples were cultured on Sabouraud's Dextrose Agar (SDA),
and analysed using India ink preparation and cryptococcal
antigen detection by the rapid Latex Agglutination assay.
Results: Mean age of the patients was 32.45 years. The male:
female ratio was observed to be 10:1. Of these, 30 (14.70%)
cases were culture positive, 35 (17.15%) were positive for
cryptococcal antigen and 16 (7.84%) patients were found to
be positive by India ink preparation. Incidence of cryptococcal
meningitis was observed to be 14.70% in the study population.
Considering culture as gold standard, the sensitivity and
specificity of India ink was observed to be 53.33% and 100%
respectively. The antigen detection test showed the sensitivity
and specificity of 100% and 97.12%, respectively.
Conclusion: Rapid and early diagnosis of cryptococcal
infection by detection of the fungal antigen in CSF of patients
by latex agglutination when compared to culture and India ink
can alter the course of management of cryptococcal meningitis
patients. |
| first_indexed | 2024-12-10T06:12:34Z |
| format | Article |
| id | doaj.art-81f3f08f22304a638b5474baf1ffd5fe |
| institution | Directory Open Access Journal |
| issn | 2277-8551 2455-6882 |
| language | English |
| last_indexed | 2024-12-10T06:12:34Z |
| publishDate | 2019-10-01 |
| publisher | JCDR Research and Publications Pvt. Ltd. |
| record_format | Article |
| series | National Journal of Laboratory Medicine |
| spelling | doaj.art-81f3f08f22304a638b5474baf1ffd5fe2022-12-22T01:59:31ZengJCDR Research and Publications Pvt. Ltd.National Journal of Laboratory Medicine2277-85512455-68822019-10-0184MO01MO0310.7860/NJLM/2019/41492:2361Cryptococcal Meningitis in HIV Patients from a Tertiary Care Centre in Northern IndiaShiwangi Sharma0Arvind Achra1Renu Kumari2Anuradha3Nandini Duggal4Senior Resident, Department of Microbiology, PGIMER and Dr Ram Manohar Lohia Hospital, New Delhi, IndiaAssistant Professor, Department of Microbiology, PGIMER and Dr Ram Manohar Lohia Hospital, New Delhi, India.Junior Resident, Department of Microbiology, PGIMER and Dr Ram Manohar Lohia Hospital, New Delhi, India.Associate Professor, Department of Microbiology, PGIMER and Dr Ram Manohar Lohia Hospital, New Delhi, IndiaProfessor and Consultant, Department of Microbiology, PGIMER and Dr Ram Manohar Lohia Hospital, New Delhi, India.Introduction: Cryptococcal meningitis, caused by Cryptococcus neoformans, an opportunistic fungal infection that affects immunocompromised Human Immunodeficiency Virus (HIV)/ Acquired Immunodeficiency Syndrome (AIDS) patients. In recent years, the incidence of cryptococcal meningitis has increased in both the HIV-positive and HIV-negative patients; therefore there is a need for development of efficient methods for early diagnosis and treatment to reduce mortality and morbidity. Aim: To determine the incidence of cryptococcal meningitis in HIV/AIDS patients and to compare the results of latex agglutination test and India ink preparation with fungal culture examination. Materials and Methods: A total of 204 Cerebrospinal fluid (CSF) samples from HIV-positive patients (aged >18 years) showing signs and symptoms of meningitis were collected. The samples were cultured on Sabouraud's Dextrose Agar (SDA), and analysed using India ink preparation and cryptococcal antigen detection by the rapid Latex Agglutination assay. Results: Mean age of the patients was 32.45 years. The male: female ratio was observed to be 10:1. Of these, 30 (14.70%) cases were culture positive, 35 (17.15%) were positive for cryptococcal antigen and 16 (7.84%) patients were found to be positive by India ink preparation. Incidence of cryptococcal meningitis was observed to be 14.70% in the study population. Considering culture as gold standard, the sensitivity and specificity of India ink was observed to be 53.33% and 100% respectively. The antigen detection test showed the sensitivity and specificity of 100% and 97.12%, respectively. Conclusion: Rapid and early diagnosis of cryptococcal infection by detection of the fungal antigen in CSF of patients by latex agglutination when compared to culture and India ink can alter the course of management of cryptococcal meningitis patients.http://www.njlm.net/articles/PDF/2361/41492_CE[Ra1]_F(SHU)_PF1(AG_SHU)_PFA(KM)_PB(AG_SHU)_PN(SHU).pdfcryptococcus neoformanscryptococcus antigenhuman immunodeficiency virusincidenceindia ink |
| spellingShingle | Shiwangi Sharma Arvind Achra Renu Kumari Anuradha Nandini Duggal Cryptococcal Meningitis in HIV Patients from a Tertiary Care Centre in Northern India National Journal of Laboratory Medicine cryptococcus neoformans cryptococcus antigen human immunodeficiency virus incidence india ink |
| title | Cryptococcal Meningitis in HIV Patients from a Tertiary Care Centre in Northern India |
| title_full | Cryptococcal Meningitis in HIV Patients from a Tertiary Care Centre in Northern India |
| title_fullStr | Cryptococcal Meningitis in HIV Patients from a Tertiary Care Centre in Northern India |
| title_full_unstemmed | Cryptococcal Meningitis in HIV Patients from a Tertiary Care Centre in Northern India |
| title_short | Cryptococcal Meningitis in HIV Patients from a Tertiary Care Centre in Northern India |
| title_sort | cryptococcal meningitis in hiv patients from a tertiary care centre in northern india |
| topic | cryptococcus neoformans cryptococcus antigen human immunodeficiency virus incidence india ink |
| url | http://www.njlm.net/articles/PDF/2361/41492_CE[Ra1]_F(SHU)_PF1(AG_SHU)_PFA(KM)_PB(AG_SHU)_PN(SHU).pdf |
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