1Senior Resident, Department of Microbiology, ESIC Model Hospital cum ODC, Mumbai
2Microbiologist, Department of Microbiology, Government Medical College, Latur
3Associate Professor, Department of Microbiology, J J hospital, Mumbai
4Senior Lab Technician, Department of Microbiology, J J hospital, Mumbai
*Corresponding author: Ashwini Waghmare Saminder, Microbiologist, Government Medical College, Latur. Email: ashwinishivani@gmail.com, Mobile: 08888493258
To study the microscopy, culture and biochemistry profile of cerebrospinal fluid (CSF) in various non-tuberculous cases of meningitis and the utility of cryptococcal latex agglutination test in HIVpositive and negative patients suspected of having cryptococcal meningitis.
Study design: Prospective. Study period: October 2007 to May 2009. The samples for the study were received from all age groups of HIV-positive patients suspected of having meningitis admitted to either medicine or paediatric ward and HIV-negative patients with signs and symptoms of meningitis were taken as control group.
After collection, CSF was subjected to the following tests: Unstained wet mount, Gram stain, Acid fast stain, India ink preparation (IIP), bacteriological & fungal culture of CSF and antigen detection test for Cryptococcus neoformans.
The prevalence of meningitis among the clinically suspected HIV-positive patients was 18.3%. The most common cause of meningitis in HIV-positive patients was S. pneumoniae (60%) followed by N. meningitidis (40%). In HIV-negative patients, the most common cause was N. meningitidis (30.8%) followed by S. Pneumoniae and K. pneumoniae (23.1% each). The other causes of meningitis were E. coli, P. aeruginosa and A. baumanii. India ink preparation, cryptococcal antigen detection test and the culture showed a correlation of 83.3% in cases of cryptococcal meningitis. It was observed that cryptococcal antigen detection test was more sensitive (100%) as compared to culture (81.8%) and India ink preparation (68.2%).
Patients with CD4 count <200 cells/μl were more prone to cryptococcal meningitis in HIV positive patients.
Cerebrospinal Fluid, Cryptococcal Meningitis, Culture, CD4 Count