CURRENT ASPECTS OF NEUROMENINGITIC CRYPTO COCCOSIS IN ABIDJAN

Neuromeningitic cryptococcosis has become increasingly important in Af rica since the advent of AIDS. From 1985-93, we have hospitalized in A bidjan 149 cases against 4 cas from 1969 to 1980. Only 2 patients were seronegative for HIV, 141 were HIV positive (94,6 %) when 6 have not been tested. Clinically the patterns were that of true meningitidis (1 7,4 %), meningoencephalitis (80,5 %), asymptomatic form (2,1 %) and di sseminated cases (8,5 %). The letality was 86,5 % but it was lower and statistically significant in protocols using fluconazole alone or in relay with amphotericine (70 %) compared to amphotericine alone or ass ociated with fluorocytosine (90,2 %). This study shows the importance and difficulties of diagnosis and therapy about cryptococcal meningiti s in Cote d'Ivoire.