Cryptococcal meningitis (C. neoformans var. gattii) leading to blindness in previously healthy Melanesian adults in Papua New Guinea
Lalloo, D.; Fisher, D.; Naraqi, S.; Laurenson, I.; Temu, P.; Sinha, A.; Saweri, A.; Mavo, B.
Quarterly Journal of Medicine 87(6): 343-349
1994
ISSN/ISBN: 0033-5622 PMID: 8041866 Document Number: 423552
Cryptococcal meningitis is a common cause of chronic meningitis in Papua New Guinea, affecting apparently immunocompetent people. The majority of infections are believed to be due to Cryptococcus neoformans var. gattii. The records of 49 Melanesian adults who presented with proven cryptococcal meningitis to the University teaching hospital in Port Moresby between September 1979 and November 1990 were reviewed and compared with other published studies of cryptococcal meningitis in the tropics and sub-tropics. None of the patients had an obvious cause of immunosuppression. Visual disturbances and fundoscopic changes of papilloedema or papillitis were particularly common. The in-hospital case fatality rate for patients treated with amphotericin B and flucytosine was 22.4%. Of the fully treated patients, 31% became completely blind before being discharged from hospital. Therapy directly aimed at reducing intracranial pressure may improve outcome.