Characterization of meningeal cryptococcosis in patients not infected with human immunodeficiency virus, hospitalized in a tertiary care institution in Bogotá, Colombia

Abstract

Introduction: Cryptococcosis is a relevant opportunistic fungal infection, fundamentally compromises the central nervous system (CNS) and is associated with high mortality in both seropositive and negative patients.

Methods: Descriptive, retrospective cross-sectional study that included medical records of hospitalized adult patients diagnosed with meningeal cryptococcosis and who met the inclusion criteria. For the quantitative variables, measures of central tendency and dispersion were calculated. The qualitative variables were grouped in frequency tables.

Results: Sample of 6 homogeneous cases, with the same incidence between sexes. Cryptococcus spp antigen in blood and CSF was positive in all cases, while RT-PCR was diagnostic in 4 patients, culture documented isolation in only two cases. Hyperproteinorrhachia, pleocytosis, hypoglycorrhachia, and increased opening pressure were the most frequent findings in the cerebrospinal fluid examination. Neuroimaging only revealed lesions compatible with infection in two patients.

Conclusions: Cryptococcal meningitis has a variable presentation that requires high clinical suspicion not only in HIV-seropositive patients, it has a highly lethal course. Diagnosis requires well-performing microbiological and molecular tests that should always be ordered and are widely available.