CRYPTOCOCCAL MENINGITIS AND HIV-INFECTION IN DAKAR

Cryptococcal meningitis cases have increased with the onset of the HIV infection, particulary in Central African countries. According to lit erature, its incidence would be low in West Africa. This retrospective study was carried out by the Fann Hospital Department of Infectious D iseases, in Dakar, from January 1, 1986 to December 31, 1996. During t his period, 7 cryptococcal meningitis were recorded for 980 AIDS cases . The mean age was 37 years and heterosexual transmission was the only HIV risk factor. Headache, vomiting, and fever were the most frequent signs of cryptococcal meningitis in this study. CSF examination with China ink coloration was positive in 6 cases. The latex agglutination test detecting the cryptococcal antigen in blood was positive in the 7 patients with a median rate of 1/5000 (range 1/1.000 to 1/10.000). In this study, only the neoformans strain was found. The death rate reac hed 85.7 % (6 deaths out of 7). This infection occurred in the late st age of immunodeficiency, when CD4 count fell to 50/mm(3). Early diagno sis and availability of intravenous Amphotericin B in Africa could imp rove the pronostic.