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2013, Number 4

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Rev cubana med 2013; 52 (4)

Acellularity of cerebrospinal fluid as adverse prognostic factor in cryptococcal meningitis

Larrea FRR, Sánchez VL

Language: Spanish
References: 11
Page: 242-253
PDF size: 207.53 Kb.


ABSTRACT

Introduction: opportunistic diseases, and among them, cryptococcal meningitis in immune-compromised patients, are a major cause of lethality in developing countries.
Objective: to identify mal prognostic factors such as acellularity of cerebrospinal fluid (CSF) to identify therapeutic measures aimed to achieve improved survival and quality of life of these patients.
Methods: cellularity was studied in all CSF of the 170 cases in Bojanala, North West, who were admitted to the Rustenburg Provincial Hospital, South Africa for cryptococcal meningitis from May 2001 to April 2004. The number of CSF white cell with hospital mortality, seropositive human immunodeficiency virus (HIV) and level of T4 lymphocytes were interrelated.
Results: a highly significant association was found between baseline CSF acellularity and risk of death, and significant linear progression of increased mortality in patients with developmental decline in the number of white cells in successive CSF. A high fatality rate (36.5 %) for cryptococcal meningitis was also found. No significant differences was found between acellularity and lethality tests comparing groups according to the level of T4 lymphocytes and the confirmation or otherwise of HIV seropositivity.
Conclusions: both basal acellularity and evolutionary downward progression of the number of CSF white cells are useful tools for predicting the risk of death for cryptococcal meningitis.


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