Cryptococcus neoformans meningitis: a report of 109 cases

Abstract

Objective To analyze the clinical features and prognosis of Cryptococcus neoformans meningitis.Methods Patients (n =109) with anti-HIV negative who were diagnosed as having Cryptococcus neoformans meningitis were enrolled.The epidemiological data,clinical manifestations,laboratory examination,treatments and outcomes were analyzed.Results The main clinical manifestations of patients with Cryptococcus neoformans meningitis were severe headache,fever,increased intracranial pressure,and positive meningeal stimulation.Of 109 patients,9.2％ had basic disease,19.3％ had dove and poultry exposure history,61.4％ lived in eucalyptusplanting area.All patients showed increase in intracranial pressure,with 37.6％ higher than 330 mm H2O (1mmH2O=0.098 kPa).Ink staining smear for Cryptococcus neoformans showed a positive rate of 67.0％ for the first time and 100.0％ positive after repeated lookup.Cerebrospinal fluid culture detected 89.0％ positive of Cuptococcus neoformans.The total therapeutic efficiency was 85.3％ (93/109) with a mortality of 14.7％(16/109).Conclusions Patients with fever,severe headache and intracranial pressure increased should be considered as having cryptococcal meningitis if they have a dove exposure history or live in eucalyptus-planting area.Once the diagnosis is made,measures like active control of intracranial pressure and administration of full dose and course of antifungal drugs should be taken to improve the cure rate and reduce the fatality rate. Key words: Cryptococcus neoformans ; Meningitis ; Clinical analysis