Journal Article

Cryptococcal Meningitis in Human Immunodeficiency Virus-Infected Patients in Harare, Zimbabwe

Robert S. Heyderman, Innocent T. Gangaidzo, James G. Hakim, Jens Mielke, Albert Taziwa, Praise Musvaire, Valerie J. Robertson and Peter R. Mason

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 26, issue 2, pages 284-289
Published in print February 1998 | ISSN: 1058-4838
Published online February 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/516298
Cryptococcal Meningitis in Human Immunodeficiency Virus-Infected Patients in Harare, Zimbabwe

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A prospective observational study was conducted over a 10-month period to determine the clinical and laboratory manifestations of cryptococcal meningitis in Zimbabwe, a country where antifungal agents are not widely available. Eighty-nine patients with cryptococcal meningitis (median age, 34 years; range, 11–63 years; 56 males) were identified from 406 patients for whom a clinical diagnosis of meningitis had been made. All patients tested were positive for antibody to human immunodeficiency virus. Cryptococcal meningitis was the first AIDS-defining illness in 88% of patients. Typical presentations were headache, mental impairment, and meningism (median duration, 14 days; range, 1–180 days). The median CD4+ cell count was 70/lμL (range, 0–651/μL). The cumulative median survival from the time of diagnosis was 14 days (range, 0–233 days); 22% of patients survived for >30 days. Independent indicators of a good prognosis were not identified. This study provides a unique basis for the development of novel management strategies for patients with cryptococcal meningitis who reside in resource-poor countries.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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