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Dollo I, Marih L, El Fane M, Es-Sebbani M, Sodqi M, Oulad Lahsen A, Chakib A, El Kadioui F, Hamdani A, El Mabrouki MJ, Soussi Abdallaoui M, Karima Z, Hassoune S, Maaroufi A, Marhoum El Filali K. [Retrospective study of neuromeningeal cryptococcosis in patients infected with HIV in the infectious diseases unit of university hospital of Casablanca, Morocco]. J Mycol Med 2016; 26:331-336. [PMID: 27520534 DOI: 10.1016/j.mycmed.2016.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 06/21/2016] [Accepted: 06/24/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To report the cases of neuromeningeal cryptococcosis and to describe the clinical, paraclinical, therapeutic and outcomes of patients. PATIENTS AND METHODS Retrospective study of 43 patients infected with HIV admitted from January first 2010 to June 30th 2015 in the infectious disease unit of UHC Ibn Rochd, for neuromeningeal cryptococcus. RESULTS The mean frequency of neuromeningeal cryptococcosis in patients infected with HIV was 1.4%. The mean age was 39 years and a sex ratio of 1.38. The mean CD4 count was 70 cells/mm3. The diagnosis of HIV was revealed by neuromeningeal cryptococcus in 77% of cases. Fifteen days interval was reported between the first symptom and hospital admission. Headache (77%) was the most represented clinical sign. The cerebrospinal fluid analysis showed hypoglycorachy (67%), hyperproteinorachy (65%) and lymphocytosis (63%). Chinese ink direct examination for Cryptococcus neoformans in CSF was positive in 86% of cases and all cases were positive after culture on Sabouraud's medium. Patients were treated with monotherapy amphotericin B (42%) or fluconazole (28%) and bitherapy amphotéricine B/fluconazole (28%). Fatal evolution was observed in 60% of cases. CONCLUSION Neuromeningeal cryptococcosis remains a severe opportunistic infection in HIV patients with a heavy mortality rate.
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Affiliation(s)
- I Dollo
- Service des maladies infectieuses, CHU Ibn Rochd, Casablanca, Maroc.
| | - L Marih
- Service des maladies infectieuses, CHU Ibn Rochd, Casablanca, Maroc
| | - M El Fane
- Service des maladies infectieuses, CHU Ibn Rochd, Casablanca, Maroc
| | - M Es-Sebbani
- Service des maladies infectieuses, CHU Ibn Rochd, Casablanca, Maroc
| | - M Sodqi
- Service des maladies infectieuses, CHU Ibn Rochd, Casablanca, Maroc
| | - A Oulad Lahsen
- Service des maladies infectieuses, CHU Ibn Rochd, Casablanca, Maroc
| | - A Chakib
- Service des maladies infectieuses, CHU Ibn Rochd, Casablanca, Maroc
| | - F El Kadioui
- Laboratoire de parasitologie-mycologie, CHU Ibn Rochd, Casablanca, Maroc
| | - A Hamdani
- Laboratoire de parasitologie-mycologie, CHU Ibn Rochd, Casablanca, Maroc
| | - M J El Mabrouki
- Laboratoire de parasitologie-mycologie, CHU Ibn Rochd, Casablanca, Maroc
| | | | - Z Karima
- Laboratoire d'épidémiologie, FACULTE de médecine de pharmacie de Casablanca, Casablanca, Maroc
| | - S Hassoune
- Laboratoire d'épidémiologie, FACULTE de médecine de pharmacie de Casablanca, Casablanca, Maroc
| | - A Maaroufi
- Laboratoire d'épidémiologie, FACULTE de médecine de pharmacie de Casablanca, Casablanca, Maroc
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Bamba S, Barro-Traoré F, Sawadogo E, Millogo A, Guiguemdé RT. [Retrospective study of cases of neuromeningeal cryptococcosis at the University Hospital of Bobo Dioulasso since accessibility to antiretroviral in Burkina Faso]. J Mycol Med 2012. [PMID: 23177811 DOI: 10.1016/j.mycmed.2011.12.074] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIMS OF THE STUDY To study the prevalence of neuromeningeal cryptococcosis since the availability of antiretroviral drugs and to determine the epidemiological profiles, clinical and biological treatment of neuromeningeal cryptococcosis cases diagnosed in the service of parasitology and mycology of university hospital center of Bobo-Dioulasso from 2002 to 2010. PATIENTS, MATERIAL AND METHODS We included all patients diagnosed with neuromeningeal cryptococcosis for which the presence of the fungi was observed on microscopic examination of cerebrospinal fluid after staining with Indian ink. Data were collected from the registers of the clinical service and from the laboratory of the university hospital center of Bobo Dioulasso. RESULTS The prevalence of neuromeningeal cryptococcosis was 1.8% (61/5129). A decrease in the prevalence was observed from 2002 to 2010 (3.1%, to 0.2%). This decrease occurred even though the number of patients treated with antiretroviral drugs increase. Headaches were the predominant clinical signs (81.9%). The CD4 median count was 56/mm(3). All patients were successfully treated with fluconazole in relay to amphotericin B intravenous. Lethality rate is 27.8%. CONCLUSION The overall prevalence of 1.8% of neuromeningeal cryptococcosis observed in this study was lower than that in previous studies in the same laboratory in 2001. The arrival of antiretroviral drugs could have contributed to the decline in the prevalence of neuromeningeal cryptococcosis in this study.
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Affiliation(s)
- S Bamba
- Service de parasitologie-mycologie, centre hospitalier universitaire Sanou Souro, BP 1091, Bobo-Dioulasso, Burkina Faso.
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