Criptococcal meningitis in HIV infected patients – a retrospective study of S.Marcos Hospital experience between 1998 and 2004

• Autor(a) principal: Ângela, Cristina
• Data de Publicação: 2009
• Outros Autores: Leal, Dina, Carvalho, Alexandre, Oliveira, Narciso, Pimentel, Teresa, Ferreira, Maria do Sameiro
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://revista.spmi.pt/index.php/rpmi/article/view/1428
• topic: meningite; criptococose; infecção VIH; hipertensão intracraniana; meningitis; Cryptococcus; HIV infection; intracranial hypertension

Cryptococcus is a fungal infection caused by Cryptococcus neoformans. This article retrospectively describes the number of HIV patients at S. Marcos Hospital diagnosed with Criptococcal meningitis, between January 1998 and July 2004. During this 66 month period 18 cases have been identified. In our series there was no correlation between the stage of the HIV infection and the clinical manifestations at the time of admission. Given that no association was found between the initial clinical manifestations and opening pressure in the initial lumbar puncture, the former can not be taken as a trustworthy indicator of the need to lighten the intracranial pressure. Our work re-emphasises the importance of evaluating the opening pressure, as a means to diagnose intracranial hypertension. The drainage of liquor, eventually backed by appropriate neurosurgical techniques, is an adequate alternative method to alleviate intracranial hypertension, when strong evidence supporting the use of medication for that purpose is scarce. The reduction of mortality and morbidity relies on an aggressive approach, which combines the use of anti-fungal therapy with external drainage, or even peritoneal shunting.