Chadli S, Aghrouch M, Taqarort N, Malmoussi M, Ouagari Z, Moustaoui F, Bourouache M, Oulkheir S
Institut supérieur des professions infirmières et techniques de santé (ISPITS), Agadir, Maroc.
Laboratoire des analyses médicales, centre hospitalier régional Hassan II, Agadir, Maroc.
J Mycol Med. 2018 Mar;28(1):161-166. doi: 10.1016/j.mycmed.2017.10.006. Epub 2017 Nov 11.
Neuromeningeal cryptococcosis (NMC) is a severe and fatal opportunistic infection. Lethality is frequent in the absence of treatment, especially in the presence of HIV co-infection.
To determine the prevalence, epidemiological, clinical, biological and therapeutic aspects as well as the evolution of NMC for patients infected with HIV.
This is a retrospective study of 40 cases of neuromeningeal cryptococcosis diagnosed in HIV-infected patients. Data are collected for 7 years (from January 2010 to December 2016) in the registers of the parasitology laboratory and the infectious diseases department at the regional hospital center in Agadir.
A reduction in the prevalence of neuromeningeal cryptococcosis in HIV-infected patients was noted from 2010 to 2016 (3.66% to 0.83%). The overall prevalence of NMC was 1.53%. The mean age was 37±10 years old, with 90% of patients aged less than 45 years. The main clinical symptomatology was headache (75%). The main cytochemical abnormalities of cerebrospinal fluid analysis were hyperproteinorachy (60%), hypoglycorachy (63%) and lymphocytosis (50%). The mean CD4 cell count was 47/mm. Patients were initially treated with amphotericin B, relayed with fluconazole. The overall lethality was 35%.
Neuromeningeal cryptococcosis is a serious opportunistic infection in patients HIV-infected, and the lethality rate remains unacceptable. Fighting NMC in HIV+ patients requires early diagnosis, increased access to antiretrovirals, rapid introduction of appropriate treatment and the prescription of effective systemic antifungals.
神经脑膜隐球菌病（NMC）是一种严重的致命性机会性感染。在未接受治疗的情况下，尤其是合并感染艾滋病毒时，致死率很高。
确定艾滋病毒感染患者中神经脑膜隐球菌病的患病率、流行病学、临床、生物学和治疗方面以及病情演变。
这是一项对40例艾滋病毒感染患者诊断为神经脑膜隐球菌病的回顾性研究。数据收集自阿加迪尔地区医院中心寄生虫学实验室和传染病科7年（2010年1月至2016年12月）的登记记录。
2010年至2016年期间，艾滋病毒感染患者中神经脑膜隐球菌病的患病率有所下降（从3.66%降至0.83%）。神经脑膜隐球菌病的总体患病率为1.53%。平均年龄为37±10岁，90%的患者年龄小于45岁。主要临床症状为头痛（75%）。脑脊液分析的主要细胞化学异常为蛋白含量增高（60%）、糖含量降低（63%）和淋巴细胞增多（50%）。平均CD4细胞计数为47/mm。患者最初接受两性霉素B治疗，随后改用氟康唑。总体致死率为35%。
神经脑膜隐球菌病是艾滋病毒感染患者的一种严重机会性感染，致死率仍然不可接受。在艾滋病毒阳性患者中对抗神经脑膜隐球菌病需要早期诊断、增加抗逆转录病毒药物的可及性、迅速引入适当治疗以及开具有效的全身性抗真菌药物。
