Infections due to Cryptococcus neoformans in HIV-infected patients: a 27 case-based review

Abstract

Objectives: To analyze the epidemiological, clinico-paraclinical, therapeutic and evolutionary profile of HIV-infected patients who have had Cryptococcal neoformans infection.

Methodology: A retrospective study of 27 patients with HIV infection followed at the Infectious Diseases Department of Mohamed VI University Hospital and hospitalized for Cryptococcus neoformans infection between January 2007 and July 2018.

Results: The prevalence was 3.37%. The mean age of the patients was 39.22 years with a male predominance (21 men, 77.7%). Cryptococcosis was indicative of HIV infection in 16 patients (60%). Neuromeningeal localization was present in 25 patients (92.6%). Headache dominated the clinical picture in 23 patients (85%). The Indian ink test isolated cryptococcus in the CSF in 21 patients (78%) and Salbouraud culture in 22 patients (81.5%). The extension assessment showed positive blood cultures to Cryptococcus neoformans in 7 patients (26%). The average CD4 cell count was 56 cells / mm3. Eleven patients (40%) were treated with Amphotericin B + Fluconazole and 16 patients (60%) with Fluconazole monotherapy. The evolution was favorable in 22 patients (81.5%)

Conclusion: The frequency and severity of cryptococcal neoformans infection in HIV-infected patients requires screening even in the absence of clinical signs in patients with profound immunosuppression