Cryptococcal infections of the central nervous system: an analysis of predisposing factors, laboratory findings and outcome in patients from South India with special reference to HIV infection.

The incidence of cryptococcosis in patients with AIDS is significant. Predisposing factors, laboratory findings and outcome were assessed in 60 patients with cryptococcal infections of the central nervous system over a 17.5-year period (Jan. 1978-June 1995). Predisposing factors for cryptococcal infection were identified in 36 patients, with HIV infection being the commonest (18). Cryptococcal cultures were positive in all patients. India ink staining was positive in 48 patients and cryptococcal antigen was detected in 35 of 36 patients tested. Comparison of clinical and laboratory parameters between HIV-positive and HIV-negative patients showed that CSF cell response was poorer, culture of cryptococci from non-neural sites was more frequent and mortality was higher in the HIV-positive group. Although not statistically significant, concurrent systemic infections, especially tuberculosis, were more frequent in the HIV-positive group.