Changing scenario of cryptococcosis in a tertiary care hospital in north India
Chakrabarti, A.; Sharma, A.; Sood, A.; Grover, R.; Sakhuja, V.; Prabhakar, S.; Varma, S.
Indian Journal of Medical Research 112: 56-60
2000
ISSN/ISBN: 0019-5340 PMID: 11037679 Document Number: 522969
With the increase in the number of patients with AIDS, the incidence of cryptococcosis is on the increase in India. Predisposing factors, laboratory investigations and outcome of patients with cryptococcosis in this changed environment were investigated. 58 patients with cryptococcosis were retrospectively assessed during a 5-year period (January 1995-December 1999) at the Nehru Hospital, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh. The annual incidence of cryptococcosis in PGIMER increased about 15-fold from 1970-82 (pre AIDS era) to 1995-99 (present series). Of the 47 patients studied for predisposing factors, these were identified in 36. HIV infection was the most common predisposing factor (57.4%) followed by haematological malignancies (6.3%) and renal transplant (4.2%). 41 patients were diagnosed by isolation of the organism as well as antigen detection in cerebrospinal fluid/serum, 9 by isolation alone and 8 by antigen detection alone. Quantitative antigen titres were done in 38 patients and a significantly higher (P<0.01) antigen titre (>512) was observed in HIV positive patients compared to HIV negative patients. All isolates tested were of Cryptococcous neoformans var. neoformans biotype and no resistance to antifungal agents was noted. Twenty of 41 patients receiving treatment improved.