Cryptococcal meningitis in Lubumbashi, DR Congo: Clinical Expressions and Diagnostic Procedures

The aim of this study was to describe the clinical, para clinical and evolutionary aspects of Cryptococcal meningitis in the HIV infection Methods: This cross-sectional study collected clinical information from Cryptococcal meningitis patients with confirmed cerebral meningitis from 2011-2014 at Excellent Center. Fluconazole was the choice drug. The odds ratio and its 95 % confidence intervall were exprimed. The frequencies, the values of trends and dispersion were calculated. The Kappa coefficient was expressed to determine the relation among categorical variables matched the titer of Cryptococcal antigen. Results: This study involved 52 patients. The meningeal syndrome was poorly represented 3 (5, 8%). Toxoplasmosis 14 (26.9%) was associated with signs of lateralization (OR=11, 95% CI=2.8-50, p=0.001). Cryptococcal meningitis was found in patients who were on antiretroviral in 38 (73.1%). A regression of clinical symptoms was observed in 26 (50%) who completed the treatment. The evolution was fatal in 26 (50%). Co-infections (OR=7, 5, 95% CI=2,002-28, p=0,003), and combination treatment (OR=16, 95% CI=3, 1-84, 2, p=0,000) were associated with the high lethality. The median TCD4+ lymphocytes count and IQR at diagnosis of Cryptococcal meningitis were 155 cell/mm3 IQR (88-243) .The Kappa coefficient from matching the titer of Cryptococcal meningitis was 1. Conclusion: The title of Cryptococcal antigen should be interpreted in light of the evolution of clinical and duration required for treatment of cryptococcosis. Accessibility to the technical platform in this context seems urgent to improve the care of patients.