Cryptococcal Meningitis in a Newly Diagnosed AIDS Patient: A Case Report

Abstract

BACKGROUND: Cryptococcus neoformans is a very important cause of fungal meningitis in immunosuppressed patients
OBJECTIVE: To describe a case of cryptococcal meningoencephalitis
in an HIV/AIDS patient from the University of Ilorin Teaching Hospital.
METHODS: An 18 -year -old male student presented with cough, weight loss, and fever. He was clinically assessed and had full laboratory investigations including cerebrospinal fluid CSF and then started on chemotherapy. Both the clinical and neurological evaluation of the patient was described along with the laboratory analyses of his CSF. Outcome of how he was managed was also reported.
RESULTS: Cryptococcus neoformans presented as an AIDS defining fungal infection for the first time in this 18 year old undergraduate who was infected probably from transfusion of unscreened blood He had advanced HIV infection (CD4+ count of 29cells/ul) and severe cryptococcal meningoencephalitis. He was unsuccessfully managed with fluconazole, a second choice drug for this condition, amphotericin B being not
available.
CONCLUSION: Nigerians should have access to effective blood transfusion services at all public and private hospitals across the country. The National Essential Drug list should be expanded to include drugs such as amphotericin B which hitherto were considered exotic.

WAJM 2009; 28(5): 343–346.

Keywords: AIDS, Cryptococcus, meningoencephalitis, Case report.