[Cryptococcal meningitis in HIV-infected patients at Bobo-Dioulasso hospital (Burkina Faso)]

Abstract

Cryptococcus neoformans is an important fungal pathogen in immunocompromised patients. A retrospective study was conducted to investigate the occurrence of Cryptococcus neoformans infection in patients admitted to Bobo-Dioulasso Hospital over a 3 year-period. During this period, cryptococcal meningo-encephalitis was diagnosed in 36 individuals. The median age of the patients under study was 34.25 years. There was a male preponderance (24 males/12 females) in our report. Typical presentations were persistent headaches (27 cases/36), neck stiffness (16/36), altered consciousness (14/36), fever (12/36) and convulsions (9/36). Oral candidiasis coexisted with cryptococcal meningitis in 7 patients. HIV serology was positive in all patients. At diagnosis, lymphocytes counts were < 1500/mm3 in 66.66% patients. CSF examination with India ink helped to the diagnosis of cryptococcosis in all cases. Cryptococcus neoformans was associated with Streptococcus pneumoniae in 4 patients. 15/36 patients died within 1 to 29 days after admission. High mortality was related to delayed diagnosis. Cryptococcal meningitis highly contributes to mortality in HIV-infected patients in Burkina Faso and it may occur in patients not severely immunocompromised patients. A need exists to improve strategies for clinical management of AIDS patients in poor African countries.