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Cryptococcal meningitis: An under-reported disease from the hills of Uttarakhand: A hospital-based cross-sectional study

BACKGROUND: Cryptococcal meningitis is a fatal opportunistic neuroinfection and an AIDS defining illness. It can also occur in non-HIV patients who are immunodefecient due to chronic glucocorticoid use, organ transplantation, malignancy and sarcodiosis. MATERIALS AND METHODS: A cross-sectional study...

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Autores principales: Mohanty, Aroop, Bhatia, Mohit, Kabi, Ankita, Chatterjee, Kuhu, Kaistha, Neelam, Omar, Balram Ji, Gupta, Puneet K., Gupta, Pratima
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6618182/
https://www.ncbi.nlm.nih.gov/pubmed/31334171
http://dx.doi.org/10.4103/jfmpc.jfmpc_216_19
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author Mohanty, Aroop
Bhatia, Mohit
Kabi, Ankita
Chatterjee, Kuhu
Kaistha, Neelam
Omar, Balram Ji
Gupta, Puneet K.
Gupta, Pratima
author_facet Mohanty, Aroop
Bhatia, Mohit
Kabi, Ankita
Chatterjee, Kuhu
Kaistha, Neelam
Omar, Balram Ji
Gupta, Puneet K.
Gupta, Pratima
author_sort Mohanty, Aroop
collection PubMed
description BACKGROUND: Cryptococcal meningitis is a fatal opportunistic neuroinfection and an AIDS defining illness. It can also occur in non-HIV patients who are immunodefecient due to chronic glucocorticoid use, organ transplantation, malignancy and sarcodiosis. MATERIALS AND METHODS: A cross-sectional study was conducted in a tertiary care hospital from July to December 2018. CSF samples of 364 patients were received by Microbiology laboratory during this period for the purpose of aerobic bacterial, fungal and TB culture, respectively. All samples were subjected to examination by direct wet mount, Gram stain and India ink preparation. Ziehl Neelsen staining, solid culture for Mycobacterium tuberculosis on Lowenstein Jensen medium and Gene Xpert was also performed on all CSF samples. These samples were further subjected to fungal culture on Sabouraud's dextrose agar. Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry (MALDI-TOF-MS) was used for identifying all bacterial (except M. tuberculosis) and fungal isolates. RESULTS: Out of 364 CSF samples received, 288 were sterile after 48 hours of aerobic incubation. Bacterial isolates, M. tuberculosis and Cryptococcus spp. were obtained in culture from 51, 21 and 4 samples, respectively. The prevalence of cryptococcal meningitis in our study was 1.09% (4/364). Cryptococcus neoformans var grubii was the most common isolate (2/4; 50%) followed by Cryptococcus neoformans var neoformans (1/4; 25%) and Cryptococcus neoformans var gattii (1/4; 25%), respectively. CONCLUSION: Cryptococcal meningitis is a rapidly fatal condition which requires a high index of suspicion and calls for a collective effort from family physicians and diagnosticians alike. This disease is under-reported from Uttarakhand and therefore calls for further research from this region.
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spelling pubmed-66181822019-07-22 Cryptococcal meningitis: An under-reported disease from the hills of Uttarakhand: A hospital-based cross-sectional study Mohanty, Aroop Bhatia, Mohit Kabi, Ankita Chatterjee, Kuhu Kaistha, Neelam Omar, Balram Ji Gupta, Puneet K. Gupta, Pratima J Family Med Prim Care Original Article BACKGROUND: Cryptococcal meningitis is a fatal opportunistic neuroinfection and an AIDS defining illness. It can also occur in non-HIV patients who are immunodefecient due to chronic glucocorticoid use, organ transplantation, malignancy and sarcodiosis. MATERIALS AND METHODS: A cross-sectional study was conducted in a tertiary care hospital from July to December 2018. CSF samples of 364 patients were received by Microbiology laboratory during this period for the purpose of aerobic bacterial, fungal and TB culture, respectively. All samples were subjected to examination by direct wet mount, Gram stain and India ink preparation. Ziehl Neelsen staining, solid culture for Mycobacterium tuberculosis on Lowenstein Jensen medium and Gene Xpert was also performed on all CSF samples. These samples were further subjected to fungal culture on Sabouraud's dextrose agar. Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry (MALDI-TOF-MS) was used for identifying all bacterial (except M. tuberculosis) and fungal isolates. RESULTS: Out of 364 CSF samples received, 288 were sterile after 48 hours of aerobic incubation. Bacterial isolates, M. tuberculosis and Cryptococcus spp. were obtained in culture from 51, 21 and 4 samples, respectively. The prevalence of cryptococcal meningitis in our study was 1.09% (4/364). Cryptococcus neoformans var grubii was the most common isolate (2/4; 50%) followed by Cryptococcus neoformans var neoformans (1/4; 25%) and Cryptococcus neoformans var gattii (1/4; 25%), respectively. CONCLUSION: Cryptococcal meningitis is a rapidly fatal condition which requires a high index of suspicion and calls for a collective effort from family physicians and diagnosticians alike. This disease is under-reported from Uttarakhand and therefore calls for further research from this region. Wolters Kluwer - Medknow 2019-06 /pmc/articles/PMC6618182/ /pubmed/31334171 http://dx.doi.org/10.4103/jfmpc.jfmpc_216_19 Text en Copyright: © 2019 Journal of Family Medicine and Primary Care http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Mohanty, Aroop
Bhatia, Mohit
Kabi, Ankita
Chatterjee, Kuhu
Kaistha, Neelam
Omar, Balram Ji
Gupta, Puneet K.
Gupta, Pratima
Cryptococcal meningitis: An under-reported disease from the hills of Uttarakhand: A hospital-based cross-sectional study
title Cryptococcal meningitis: An under-reported disease from the hills of Uttarakhand: A hospital-based cross-sectional study
title_full Cryptococcal meningitis: An under-reported disease from the hills of Uttarakhand: A hospital-based cross-sectional study
title_fullStr Cryptococcal meningitis: An under-reported disease from the hills of Uttarakhand: A hospital-based cross-sectional study
title_full_unstemmed Cryptococcal meningitis: An under-reported disease from the hills of Uttarakhand: A hospital-based cross-sectional study
title_short Cryptococcal meningitis: An under-reported disease from the hills of Uttarakhand: A hospital-based cross-sectional study
title_sort cryptococcal meningitis: an under-reported disease from the hills of uttarakhand: a hospital-based cross-sectional study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6618182/
https://www.ncbi.nlm.nih.gov/pubmed/31334171
http://dx.doi.org/10.4103/jfmpc.jfmpc_216_19
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