Journal of Infectious Diseases & Therapy
Open Access

Abstract

Cryptococcal meningitis is one of the most common opportunistic infections (OIs) in HIV patients and affects one million people per year worldwide, resulting in 625,000 deaths. The aim of our study was to examine the association between the clinical and laboratorial findings of cryptococcal meningitis cases with antifungal minimum inhibitory concentration (MICs) and molecular types of the etiological agents and risk factors associated with in-hospital mortality. Data from 34 patients were reviewed, retrospectively. Regarding the susceptibility test for fluconazole (FLU), using a cutoff of 8 �?¼g/mL and 16 �?¼g/mL, there were no significant differences between clinical presentation, cytological analyses of CSF, time to sterilize the CSF, isolation of fungus at another site, molecular type, previous diagnosis of cryptococcal meningitis or the use of FLU and overall mortality. There was a statistical association between mortality and patients who did not have sterilized CSF (p=0.002) when lacking of neurosurgical shunt (p=0.021) and in those who presented with other OIs (p=0.037). In addition, patients who died presented with a higher yeast count (median 1720 cells/mcL) in the first CSF level than those who survived (median 351 cells/mcL) (p=0.021). Patients who presented with yeast cell counts >400/mm3 were associated with greater lethality when compared with â�?¤400 (p=0.014). We concluded that cryptococcal meningitis is difficult to manage and that the aspects associated with greater mortality should be analyzed carefully. The clinical role of MIC is uncertain, and there is no good evidence for its use in routine practice.

Biography

Marcia de Souza Carvalho Melhem is a Pharmacist and has completed her MSc and PhD from Sao Paulo University in Public Health. She is a Scientific Researcher and Master’s/Doctorate Advisor at Secretary of Health of the Government of Sao Paulo State. She has published about 60 papers in reputed journals and has been serving as a Reviewer Member.

Email: melhemmr@uol.com.br