Cryptococcosis Neuro-Brain in 42 Patients at the University Hospital of Brazzaville
Ossibi Ibara Bienvenu Rolland, Mabiala Babela Jean Robert, Attinsounon Cossi Angelo, Atipo Ibara Ollandzobo Lucie, Sekangue Obili Geril, Gouesse Grace, Angonga Pabota Ella, Boumandouki Pau Jean Claude, Puruhence Marie Francke and Obengui
American Journal of Infectious Diseases
To describe epidemiological, clinical, therapeutic; and evolutionary aspects of Neuromeningeal Cryptococcus (NMC) at Brazzaville University Hospital and to find out factors associated to death. A descriptive and analytical retrospective study of NMC files in the infectious diseases department between January 1 and December 31, 2013. 973 patients were hospitalized, 42 NMC cases (4.3%) were compiled. The mean age was 40.2±10.4 years (17-64 years). The sex ratio M/F was 1.1. The majority (n=23) came from an urban area. HIV infection (n=37-88.1%) was the main point with an average of lymphocyte LTCD4 with 101.3±123.58/mm3. The average patient consultation time was 27.5±33.6. Fever (n=36, 85.7%), headache (n=11, 26.2%) and consciousness disorders (n=13, 31.0%) were the primary reasons for consultation. LCR was clear in 32 patients and neuromeningeal Cryptococcus was confirmed by CSF in all patients (n=42,100%). Treatment was fluconazole (800-2000 mg) in all patients. No adverse effects related to fluconazole were noticed. Six patients underwent lumbar puncture discharge and 23 patients (54.8%) were on antiretroviral therapy. The lethality was 74.0% (n=31), with no significant difference depending on the stage of immunosuppression and etiologic treatment. It was significantly higher in comatose patients with Glasgow ≤8. Neuromeningeal Cryptococcus is a frequent opportunistic infection in our service with high lethality. This shows how important is the prevention which implies the early management of HIV infection.
© 2018 Ossibi Ibara Bienvenu Rolland, Mabiala Babela Jean Robert, Attinsounon Cossi Angelo, Atipo Ibara Ollandzobo Lucie, Sekangue Obili Geril, Gouesse Grace, Angonga Pabota Ella, Boumandouki Pau Jean Claude, Puruhence Marie Francke and Obengui . This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.