S Chadli1, M Aghrouch2, N Taqarort3, M Malmoussi4, Z Ouagari4, F Moustaoui2, M Bourouache5, S Oulkheir6. 1. Institut supérieur des professions infirmières et techniques de santé (ISPITS), Agadir, Maroc. Electronic address: schadli@gmail.com. 2. Laboratoire des analyses médicales, centre hospitalier régional Hassan II, Agadir, Maroc. 3. Faculté polydisciplinaire de Taroudant, université Ibn Zohr, Agadir, Maroc. 4. Service des maladies infectieuses, centre hospitalier régional Hassan II, Agadir, Maroc. 5. Faculté des sciences, université Ibn Zohr, Agadir, Maroc. 6. Institut supérieur des professions infirmières et techniques de santé (ISPITS), Agadir, Maroc.
Abstract
INTRODUCTION: Neuromeningeal cryptococcosis (NMC) is a severe and fatal opportunistic infection. Lethality is frequent in the absence of treatment, especially in the presence of HIV co-infection. OBJECTIVE: To determine the prevalence, epidemiological, clinical, biological and therapeutic aspects as well as the evolution of NMC for patients infected with HIV. PATIENTS AND METHODS: This is a retrospective study of 40 cases of neuromeningeal cryptococcosis diagnosed in HIV-infected patients. Data are collected for 7 years (from January 2010 to December 2016) in the registers of the parasitology laboratory and the infectious diseases department at the regional hospital center in Agadir. RESULTS: A reduction in the prevalence of neuromeningeal cryptococcosis in HIV-infected patients was noted from 2010 to 2016 (3.66% to 0.83%). The overall prevalence of NMC was 1.53%. The mean age was 37±10 years old, with 90% of patients aged less than 45 years. The main clinical symptomatology was headache (75%). The main cytochemical abnormalities of cerebrospinal fluid analysis were hyperproteinorachy (60%), hypoglycorachy (63%) and lymphocytosis (50%). The mean CD4 cell count was 47/mm3. Patients were initially treated with amphotericin B, relayed with fluconazole. The overall lethality was 35%. CONCLUSION: Neuromeningeal cryptococcosis is a serious opportunistic infection in patients HIV-infected, and the lethality rate remains unacceptable. Fighting NMC in HIV+ patients requires early diagnosis, increased access to antiretrovirals, rapid introduction of appropriate treatment and the prescription of effective systemic antifungals.
INTRODUCTION:Neuromeningeal cryptococcosis (NMC) is a severe and fatal opportunistic infection. Lethality is frequent in the absence of treatment, especially in the presence of HIV co-infection. OBJECTIVE: To determine the prevalence, epidemiological, clinical, biological and therapeutic aspects as well as the evolution of NMC for patients infected with HIV. PATIENTS AND METHODS: This is a retrospective study of 40 cases of neuromeningeal cryptococcosis diagnosed in HIV-infectedpatients. Data are collected for 7 years (from January 2010 to December 2016) in the registers of the parasitology laboratory and the infectious diseases department at the regional hospital center in Agadir. RESULTS: A reduction in the prevalence of neuromeningeal cryptococcosis in HIV-infectedpatients was noted from 2010 to 2016 (3.66% to 0.83%). The overall prevalence of NMC was 1.53%. The mean age was 37±10 years old, with 90% of patients aged less than 45 years. The main clinical symptomatology was headache (75%). The main cytochemical abnormalities of cerebrospinal fluid analysis were hyperproteinorachy (60%), hypoglycorachy (63%) and lymphocytosis (50%). The mean CD4 cell count was 47/mm3. Patients were initially treated with amphotericin B, relayed with fluconazole. The overall lethality was 35%. CONCLUSION:Neuromeningeal cryptococcosis is a serious opportunistic infection in patientsHIV-infected, and the lethality rate remains unacceptable. Fighting NMC in HIV+ patients requires early diagnosis, increased access to antiretrovirals, rapid introduction of appropriate treatment and the prescription of effective systemic antifungals.
Authors: M Bourouache; R Mimouni; A Ait Alla; F Hamadi; A El Boulani; B Bihadassen; A Laktib; F Moustaoui; M Aghrouch Journal: J Environ Health Sci Eng Date: 2021-06-30