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Epidemiology of Cryptococcal Meningitis Associated with HIV in an Indian Hospital

Shalini Duggal, Nandini Duggal, Charoo Hans and Ashish Kumar Duggal

Cryptococcus neoformans is an emerging pathogen especially in the setting of HIV infected patients with meningitis. The infection usually manifests in patients with impaired cell mediated immunity. Forty six culture positive cases of cryptococcal meningitis were identified over a period of three years from a tertiary care institute in Delhi. The patients were predominantly males (91%) of reproductive age group, mostly residing in and around Delhi. Most significant co-infections were HIV infection in 93% and tuberculosis in 43.5% cases. All forty six strains belonged to Cryptococcus neoformans var grubii, molecular type VN I, mating type α (MAT α). There was 100% susceptibility to amphotericin B and azoles, one isolate was resistant to 5-fluorocytosine (MIC 64 μg/ml). Cerebrospinal fluid in symptomatic HIV patients should be carefully screened for Cryptococcus spp. which should be identified and also typed for epidemiological purposes.