[Neuromeningeal cryptococcosis and AIDS: an 11-case series from Libreville, Gabon].

Neuromeningeal cryptococcosis occurs mainly in immunodepressed patients and especially AIDS patients. The purpose of this study was to determine the clinical and prognostic features of this severe brain infection.

METHODS

This retrospective study was carried out on HIV-infected patients hospitalized for cryptococcal meningitis in the internal medicine unit of a military hospital in Libreville, Gabon from January 1, 2006 to November 31, 2009.

RESULTS

Eleven cases of cryptococcosis were identified among a total of 290 cases of AIDS. Mean patient age was 39 years. The main clinical manifestation was headache that was either isolated or associated with other cerebral signs. In all cases, cerebrospinal fluid analysis demonstrated a clear aseptic aspect with direct examination after addition of India ink showing the presence of encapsulated yeast cells identified as cryptococcus. The patient was treated with amphotericin B and fluconazole. The mortality rate was 81.8% (9/11 cases).

CONCLUSIONS

Since the manifestations of cryptococcosis during clinical AIDS are non-specific, systematic screening is recommended in AIDS patients. Early treatment could reduce mortality.