ĐẶC ĐIỂM LÂM SÀNG VÀ CẬN LÂM SÀNG CỦA VIÊM MÀNG NÃO CRYPTOCOCCUS NEOFORMANS Ở BỆNH NHÂN AIDS TẠI BỆNH VIỆN BỆNH NHIỆT ĐỚI

Abstract

Background: C. neoformans meningitis is a common opportunistic infection in HIV/AIDS with a high mortality rate. The clinical characteristics, screening strategies, prevention, and treatment of HIV/AIDS patients have undergone significant changes. Objective: To describe the clinical and laboratory course of HIV/AIDS patients with C. neoformans meningitis admitted to the Hospital for Tropical Diseases. Methods: This study employed a case series design, analyzing HIV/AIDS patients diagnosed with C. neoformans meningitis at the Hospital for Tropical Diseases. Results: 103 patients (11/2023 - 8/2024), mean age 35.7 ± 11.3. Before admission: 32% on ARV treatment, 3.8% had a history of cryptococcal meningitis, median CD4 count 20 (9–56). Co-infection with cryptococcal and tuberculous meningitis: 9.7%. Symptoms: headache (89.3%), nausea (58.3%), fever (47.6%), altered consciousness (19.4%), focal neurological signs (29.1%), with sixth cranial nerve palsy being the most common. Brain imaging abnormalities: 31.8%. CSF findings: WBC count 20 (6–81) cells/mm³, protein 0.7 (0.4–1.0) g/dL, lactate 4.2 (2.7–5.0) mmol/L, CSF-to-blood glucose ratio <0.5: 84.5%. Positive India ink staining: 99%, predominant fungal strain: *C. neoformans var. grubii* (96.1%). Conclusion: Headache is a prominent symptom in cryptococcal meningitis. Cerebrospinal fluid may appear normal even in severe meningitis. Co-infection with cryptococcal meningitis and tuberculosis is increasing.