Cerebrospinal fluid routine and cytological examination in guiding early diagnosis of cryptococcus neoformans meningitis

Abstract

Objective To explore the early diagnosis method of cryptococcus neoformans meningitis and prevent missed diagnosis and misdiagnosis. Method A retrospective analysis was used to analyze the results of cerebrospinal fluid routine and cytological examination, ink staining, and cryptococcal culture in 60 patients with cryptococcus neoformans meningitis diagnosed in our hospital from May 2015 to May 2018. Results The detection rate of cryptococcus neoformans meningitis by cerebrospinal fluid routine and cytological examination was 86.7% (52/60), which was higher than that by ink staining (70%, 42/60) and cryptococcus culture (60%, 36/60) (P<0.05). The main manifestations of cryptococcus neoformans meningitis were colorless and transparent cerebrospinal fluid, 95% of protein qualitative analysis within 2+, increased intracranial pressure, and the white blood cell count slightly increased with the average value of (137±135)×106/L, the count below 400×106/L commonly found. Conclusion Routine and cytological examination of cerebrospinal fluid can be used as an early diagnostic method for cryptococcus neoformans meningitis. Combination of ink staining and fungal culture can prevent misdiagnosis and missed diagnosis. Key words: Cryptococcal meningitis; Routine and cytological examination of cerebrospinal fluid; Ink staining; Cryptococcal culture