TITLE:
Cryptococcal Meningitis of the HIV-Infected Person in Lomé: About 102 Cases over 10 Years
AUTHORS:
Ihou Majesté Wateba, Abago Balaka, Alain Lidaw Bawe, Awereou Kotosso
KEYWORDS:
Cryptococcal Meningitis, HIV, Lomé
JOURNAL NAME:
World Journal of AIDS,
Vol.7 No.3,
September
19,
2017
ABSTRACT: Objective: To describe the clinical, epidemiological and evolutionary aspects
of cryptococcal meningitis. Methods: This was a retrospective descriptive study
on all HIV-infected patients who had been hospitalized for cryptococcal meningitis
between 2006 and 2016 in the principal structures for the care of HIV
infected person in Lomé. The diagnosis of meningitis was clinical and confirmed
by the presence of cryptococci on Chinese ink or the detection of CSFsoluble
antigens. All patients have made the CD4 rate assay and received an
antifungal treatment based on fluconazole or Amphotericin B, followed later
by antiretroviral triple therapy. Results: A total of 102 patients infected with
cryptococcal meningitis (62 men for 40 women) were found. The sex ratio was
1.55. The median age was 34 years with extremes of 15 to 49 years. Clinically,
headache was the symptomatic symptom in 100% of cases, prone to long runs
and weight loss respectively in the proportions of 45% and 65%. The mean
CD4 cell count was 65 ± 22 cells per mm3. The duration of hospital stay was
short (less than 7 days) for the deceased. A total of 62 patients were able to
receive treatment, 40 of them with fluconazole and 22 with Amphotericin B.
The mortality was very high (65%), 25% were lost to follow-up, and 9.5% still
in live 3 months after admission to the hospital. Conclusion: Cryptococcal meningitis
has a very reserved prognosis. It is to be feared in cases of severe immunosuppression,
hence the early detection of HIV for optimal management
is important.