Cryptococcosis in AIDS

A total of 87 patients (17 female, 70 male) were admitted to Siriraj Hospital, Mahidol University, Bangkok, Thailand, from January 1996 to December 1997, with a diagnosis of cryptococcal meningitis and underlying AIDS. The age range was 14-70 years, mean 32.1. Six females (35%) and thirty-one males (44%) died, while the others were discharged home after clinical improvement. The mean duration of admission of those who died was 14.5 days, which was shorter than that of the patients who survived (25.7 days). Cerebral cryptococcosis was diagnosed using culture (100%), India ink preparation (91%), latex agglutination test (100%), and polymerase chain reaction (86%). Polymerase chain reaction fingerprinting of Cryptococcus neoformans revealed 99% serotype A and 1% serotype B. The mean minimum inhibitory concentrations of amphotericin B, flucytosine, fluconazole and itraconazole against 87 isolates of C neoformans were 0.55 mu g/ml (0.25-1, SD = 0.22), 9.5 mu g/ml (2-20, SD = 4.91), 6.9 mu g/ml (1-16, SD = 4.42) and 0.36 mu g/ml (0.125-1.0, SD = 0.23), respectively. These findings showed that the cryptococcal infections were sensitive to these antifungal agents.