Cryptococcal meningitis in adults

Abstract

Retrospective studies of 22 cases with cryptococcal meaingitis who were admitted in Department of Medicine, Srinagarind Hospital during February 1984 to October 1988 were performed.  Age incidence was range from 23 years to 70 years, male to female retio was 1.75:1.  The majority of them were farmer and lived in the North-East of Thailand.  There was no seasonal variation.  Associated diseases were found in 27.2%. All of them had no history of closed contact with the pigeon.  The common presenting symptoms were headache (100%), fever (50.0%), nausea/vomiting (40.9%) and alteration of consciousness (40.9%).  Meningeal signs were found in 57.0%.  Abnormal finding of chest X-rays was 36.3%.  On admission, cerebrospinal fluid values revealed : high initial opening pressure 63.6%, white blood cell pleocytosis 91.0%, high protein 77.1% hypoglycorrhachia 86.2%, positive india ink stain 63.1%, positive culture 89.4% and positive cryptococcal antigen 85.7%.  After treatment, 59.0% of the patients were improved.  Relapsed rate was 15.3%.  Less than 20 leukocytes/cu.mm. in cerebrospinal fluid was the poor prognostic factor.