Epidemiological and therapeutic aspects of neuromeningeal cryptococcosis at the Department of Infectious and Tropical Diseases of the Point G Teaching Hospital Center.

Abstract

Introduction: Neuro-meningeal cryptococcosis (CNM) is the second opportunistic disorder of the nervous system associated with HIV infection. The objective of this work was to determine the epidemiological clinical aspects and the prognosis of CNM. Material and methods: We conducted a retrospective analytical and prospective study of patients hospitalized for neuro-meningeal cryptococcosis in the infectious and tropical diseases department of the G-spot CHU, from January 1, 2006 to December 31, 2016. The diagnostic criterion for CNM was detected for Cryptococci by staining with Indian ink, and or by culture in cerebrospinal fluid (CSF).Results: Out of 4,169 patients hospitalized in the department during the study period 32 patients or 0.8% of hospitalizations had CNM. The male sex was the most represented with a sex ratio of 2.2. On admission 34.4% of our workforce had impaired consciousness and 81.3% were immunosuppressed to HIV. On a total of 25, the CD4 count was less than 100 cells / mm³ in 96% of cases. We found a statistically significant link between the molecule used in the initial phase of treatment and the course. The mortality rate was high in the study, at 62.5%.  Conclusion: CNM is a rare opportunistic disease but the case fatality rate is still very high, especially in developing countries. The suitability of the technical platform and the availability of first-line anti-fungal molecules are the key to improving the prognosis of these patients