SANP

Swiss Archives of Neurology, Psychiatry and Psychotherapy

2297-7007 2297-6981

EMH Schweizerischer Ärzteverlag AG

Farnsburgerstrasse 8 CH-4132 Muttenz

03035

10.4414/sanp.2019.03035

Original article

Infectious disorders of the nervous system

Pronostic évolutif de la cryptococcose neuroméningée au Togo

Agba

Léhleng

Guinhouya

Kokou M.

Kumako

Vincent

Kara University Teaching hospital

Anayo

Komla N.

Centre hospitalier Sylvanus Olympio

Belo

Mofou

Balogou

Agnon A. K.

17 06 2019

170 03 0 0

2019

EMH Schweizerischer Ärzteverlag AG

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<p>Introduction: Neuromeningeal cryptococcosis (NMC) is the most common mycotic meningitis infection occurring during HIV / AIDS. It is the leading cause of clear-fluid meningitis in patients with human immunodeficiency virus (HIV). Its evolutionary prognosis remains in the majority of unfavorable for several reasons. Objective: To describe the epidemiological and clinical aspects of the NMC and its evolutionary profile in adults in the medical departments of the Sylvanus Olympio Teaching Hospital of Lomé Patients and methods: This was a retrospective study from January 1, 2007 to December 31, 2016 conducted from hospital records in the medical and medical specialty services of the Sylvanus Olympio University Hospital in Lomé, Togo. Results: The hospital prevalence of the NMC was 1.2% with a male predominance (H/F=1.3). The average age of the patients was 34.58 years old, with a high representation of the 30-39 and 20-29 age groups. Civil servants (23.91%), students (15.21%), traders (15.21%) were the most affected. The main reasons for admission were fever (73.9%), headache (69.5%), seizures (56.5%) and vomiting (45.6%). The main physical signs were general impairment syndrome (95.6%), infectious syndrome (91.3%) meningeal syndrome (84.7%) and confusional syndrome (58.6%). All our patients were HIV-positive1 and 97.72% had a CD4 count of less than 100. The CSF examination allowed the diagnosis to be made by direct examination with Chinese ink in 93.47% of patients or to culture in the case of negativity on direct examination (6.53%). The treatment was made of Amphotericin B and Flucitosin in 17.39% of cases and Fluconazole in 82.60% of cases. Treatment progress was marked by death in all our patients occurring after an average of 17.34 days of hospitalization. Conclusion: Because of its high mortality rate, NMC is a diagnosis to be considered in principle in HIV-positive patients with headache, fever or confusional syndrome.</p>