Clinical analysis on 100 cases of AIDS combined with cryptococcal meningitis

Objective To analyze the clinical features and prognosis of cryptococcal meningitis in patients with AIDS,and to improve the understanding of cryptococcal meningitis.Methods We retrospectively analyzed the clinical data of cryptococcal meningitis in patients with AIDS from January 2008 to December 2012 in Guangzhou 8th People's Hospital.The data of clinical manifestation,laboratory examination,treatment and prognosis were collected.Results Among all 100 cases diagnosed as AIDS associated with cryptococcal meningitis,75 cases were male and 25 cases were female,mean age was (39.5 ± 10.3) years old.Charlson comorbidity index was (6.1 ± 0.7).All patients were not receiving HAART.Fever and headache were the most common clinical symptoms.CD4 cell count was 1～ 139/μ l (median 8.5).98 patients had increased open pressure [mean (21.2 ± 12.4) mmHg].Median CSF WBC count was 2 (1-110) × 106/L,the median protein quantification was 0.41 g/L (0.11-1.43 g/L),median glucose 0.42 g/L (0.05-0.69 g/L).88 patients had positive India ink smear,81 patients were cerebrospinal fluid culture positive,88 cases had positive CSF cryptococcal antigen and 99 patients were serum cryptococcal antigen positive.The median duration was 23 days.There were no significant difference of clinical outcomes among different treatment groups (x 2=4.387,P=0.821).Conclusion Cryptococcal meningitis is the common opportunistic infection in patients with AIDS.The clinical manifestations and laboratory tests lack specificity.The key to reducing mortality is early diagnosis and rational use of antifungal agents. Key words: HIV;  Cryptococcal meningitis