Abstract:

Background: Cryptococcal meningitis is a chronic and very severe form of Cryptococcal infection caused by Cryptococcus neoformans. Despite the fact that it is a common opportunistic infection in patients with human immunodeficiency virus (HIV), its management in developing countries is still a challenge. This has led to poor outcome in patients who contract this disease.

Method: A prospective cross sectional study was conducted for a period of five months. All HIV-infected patients admitted to Bugando Medical Centre were screened for serum Cryptococcal antigen (SCrAg). Patients with positive test results were further investigated to identify those with Cryptococcal meningitis and were followed for outcome.

Results: A 5% enrolled patients had a positive SCrAg, and 88% of these were confirmed to have Cryptococcal meningitis. Of the patients enrolled, 28% had CD4 count below 100 and 93% patients with Cryptococcal meningitis had CD4 counts below one hundred. Altered mental status, stiffness and headache were significant clinical predictors of cryptococcal meningitis, with p-value of <0.0001, <0.0027, and 0.0406 respectively. Among 15 with cryptococcal meningitis, 10(67%) patients died in the hospital after an average of five days of treatment for cryptococcal meningitis.

Conclusion: Cryptococcal meningitis is not uncommon in HIV positive patients admitted to Bugando Medical Centre. Among HV-positive patients with CD4 counts less than 100, the prevalence was 15%. Altered mental status, neck stiffness and headache are useful clinical predictors of this disease. Cryptococcal meningitis had a very high mortality rate of 67% among HIV/AIDS patients admitted to Bugando Medical Centre.