摘要
Objective:To study disseminated cryptococcal infection in a tertiary care hospital in Southern India.Methods:The clinical profile of 12 disseminated cryptococcosis patients with the age group of 28-52 years was retrospectively analyzed.Results:7(58.3%) presented with fever 【 30 days and 3(25%) 】 30 days whereas 2(16.7%) did not have fever.All the 12(100%) had headache. 2(16.7%) had altered sensorium,one(8%) seizure.5(41.7%) had diarrhea and vomiting.6(50%) had oral candidiasis,and anemia.9(75%) had elevated erythrocyte sedimentation rate(ESR).6(50%) had neck stiffness.Cerebrospinal fluid(CSF) pressure was elevated in all 12(100%) patients. Blood culture positive for Cryptococcus neqformans(C.neoformans) in 11(91.7%) and CSF culture positive in all 12(100%),one(8%) had urine culture positive.India ink preparation was positive in 10(83.3%).CD4 count was less than 50/microl in 4(33.3%),between 50-100 in 6(50%) and 2(16.7%) in the range of 100-200.6(50%) were treated with parenteral amphotericin B(0.7 mg/kg/d) during intensive phase followed by oral fluconazole 400 mg/d for 8 weeks then maintenance oral fluconazole 200 mg/d.5(41.6%) were treated with fluconazole alone.8(66.7%) improved and 4(33.3%) patients died.Among those who succumbed to the illness,2(16.7%) received amphotericin and fluconazole,2(16.7%) patients received fluconazole alone.Conclusions:Disseminated cryptococcosis can cause considerable mortality in HIV patients and immunocompromised non- HIV individuals.At times,its presentation closely mimics that of Tuberculosis.Early diagnosis and appropriate treatment should be started as early as possible.
Objective:To study disseminated cryptococcal infection in a tertiary care hospital in Southern India.Methods:The clinical profile of 12 disseminated cryptococcosis patients with the age group of 28-52 years was retrospectively analyzed.Results:7(58.3%) presented with fever < 30 days and 3(25%) > 30 days whereas 2(16.7%) did not have fever.All the 12(100%) had headache. 2(16.7%) had altered sensorium,one(8%) seizure.5(41.7%) had diarrhea and vomiting.6(50%) had oral candidiasis,and anemia.9(75%) had elevated erythrocyte sedimentation rate(ESR).6(50%) had neck stiffness.Cerebrospinal fluid(CSF) pressure was elevated in all 12(100%) patients. Blood culture positive for Cryptococcus neqformans(C.neoformans) in 11(91.7%) and CSF culture positive in all 12(100%),one(8%) had urine culture positive.India ink preparation was positive in 10(83.3%).CD4 count was less than 50/microl in 4(33.3%),between 50-100 in 6(50%) and 2(16.7%) in the range of 100-200.6(50%) were treated with parenteral amphotericin B(0.7 mg/kg/d) during intensive phase followed by oral fluconazole 400 mg/d for 8 weeks then maintenance oral fluconazole 200 mg/d.5(41.6%) were treated with fluconazole alone.8(66.7%) improved and 4(33.3%) patients died.Among those who succumbed to the illness,2(16.7%) received amphotericin and fluconazole,2(16.7%) patients received fluconazole alone.Conclusions:Disseminated cryptococcosis can cause considerable mortality in HIV patients and immunocompromised non- HIV individuals.At times,its presentation closely mimics that of Tuberculosis.Early diagnosis and appropriate treatment should be started as early as possible.
