Journal of Vaccines & Vaccination

HIV infected patients in C.H.U. Oran and Cryptococcal meningitis

6^th Euro Global Summit and Expo on Vaccines & Vaccination

August 17-19, 2015 Birmingham, UK

Benmansour Zakaria

Posters-Accepted Abstracts: J Vaccines Vaccin

Abstract:

Introduction: Cryptococcal meningitis in HIV-infected patients is an important fungal pathogen in immunocompromised
patients. A retrospective study was conducted to investigate the occurrence of Cryptococcus neoformans infection in patients
admitted to the disease infections over one year-period. During this period, Cryptococcal meningo-encephalitis was diagnosed
in 23 individuals. The median age of the patients under study was 39.25 years. There was a male preponderance in our report.
Typical presentations were, persistent headaches (27 cases/36), neck stiffness (16/36), altered consciousness (14/36), fever
(12/36) and convulsions (9/36). High mortality was related to delayed diagnosis. Cryptococcal meningitis highly contributes
to mortality in HIV-infected patients and it may occur in patients not severely immunocompromised patients. A need exists
to improve strategies for clinical management of AIDS patients
Materials & Methods: Between January, 2013, and June 2014, 1099 takings were sent in the service of parasitology, among
which 201 cases were of LCR, 23 cases of cryptococcose.
Results: Prevalence of the meningo-encephalitis cryptococcose in the patients infected by the HIV was 0.4%. His/Her frequency
practically decreased while it was 2.09% for the ten years. The average age of the patients was 36±4.5 years old.
Discussion: The man is preferentially touched. The average deadline (extension) of evolution of the symptomatology before
hospitalization represented one week. The mode of installation of the disease is progressive with no specific clinical signs, fever,
headache, generally frontal, temporal or retro-orbitaires and resistant to analgesic, it is necessary to keep in mind that too. In
severely immunosuppressed patient, with a rate of CD4 lower than 200 by mm3, any suspicion of meningitis has to make us
look for a cryptococcose. These figures found, allowed to review the evolution of this pathology in region, Algerian West. The
isolation of the cryptocoque in the cerebrospinal fluid allows asserting the diagnosis of neuromeningeal cryptococcose with
certainty. The main cytochemical anomalies in some cerebrospinal fluid (LCR) were the CSF Protein (95.4% of the cases),
hypoglycorachie (91%) and hyperlymphocytose (100%). The search (research) for Cryptococcus neoformans in the LCR in the
direct examination after tint (coloring) in India ink has 100% specificity and a very high sensibility. The search (research) for
Cryptococcus neoformans was positive in 72.7% of the cases and after culturing in Sabouraud added with chloramphenicol in
every case (100%). An evolution most of the time mortal, in this study the death arose in 54.5 % of the cases.
Conclusion: The fight against the neuromeningeal cryptococcose necessarily has to cross (spend) by the systematic search
(research) for this affection in the subjects of HIV+ presenting headaches, the prescription of effective systematic antifungals
and by a primary prevention resting (basing) on an extension of the access to anti-retrovirals.

Biography :

Benmansour Zakaria is a Doctor in University of Medical Sciences Oran Algeria in parasitology and mycology medical laboratory. He is a researcher in the
laboratory of infectious diseases and biologically active substances in the faculty of medicine of Oran Algeria. His research work focuses on molecular fungal and
virology and vaccinology and did his PhD from parasitology and mycology department of medicine of Oran Algeria. His research included works on mycology and
parasitology infections.