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Acta Neurológica Colombiana

Print version ISSN 0120-8748On-line version ISSN 2422-4022

Abstract

HURTADO-BEDOYA, Julián David  and  RIVEROS SANTOYA, Sandra Viviana. Meningeal cryptococcosis: characteristics and clinical outcome in a tertiary care hospital in Bogotá, Colombia. Acta Neurol Colomb. [online]. 2023, vol.39, n.4, e2.  Epub Jan 18, 2024. ISSN 0120-8748.  https://doi.org/10.22379/anc.v39i4.829.

Introduction:

Meningeal cryptococcosis is a universal opportunistic infection that presents variable prognostic factors, especially in immunosuppressed patients.

Objective:

To identify clinical and paraclinical variables associated with the outcome at the end of hospitalization in patients with meningeal cryptococcosis treated at a tertiary care hospital in Bogotá, Colombia.

Materials and methods:

Descriptive observational study. The information was obtained through records of medical records of patients with a confirmed diagnosis of meningeal cryptococcosis during the period 2016-2021.

Results:

54 cases were analyzed. 85,2 % men, with a median age of 38 years. The main symptom was headache (74,1 %), with an average duration of 30 days prior to admission. 83,3 % had a diagnosis of HIV, with CD4 levels below 50 cell/mm3 and high viral load counts. The cerebrospinal fluid showed in more than 50 % intracranial hypertension, pleocytosis of lymphocyte predominance, hyperprotein- orrhachia and hypoglycorrhachia. The most frequent type of pathogen isolated was C. neoformans var neoformans. And the most prevalent variables in the group of patients who died were the presence of pleocytosis in CSF (p = 0,025), culture for positive fungus (p = 0,02) and isolation of C. neoformans var neoformans (p = 0,03).

Discussion:

Meningeal cryptococcosis is a frequent pathology in men, in the fourth decade of life and with HIV infection, however, the factors related to mortality seem to vary depending on the geographical location.

Conclusion:

In our study, the most prevalent factors were the presence of pleocytosis in CSF, positive culture, isolation of C. neoformans var neoformans.

Keywords : Colombia; cryptococcosis; observational study; opportunistic infections; prognosis; mortality; HIV.

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