La cryptococcose neuroméningée au cours de l’infection à VIH à Bangui, à l’ère du traitement antirétroviral

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• 作者：E. Gbangba-Ngai (1)
  V. Fikouma (2)
  C. D. Mossoro-Kpinde (3)
  G. Tekpa (2)
  J. O. Ouavene (1)
  D. S. A. Yangba Mongba (1)
  P. Mbelesso (2)
  
• 关键词：Cryptococcus neoformans ; Cryptococcose neuroméningée ; Traitement antirétroviral ; Amphotéricine B ; Fluconazole ; VIH ; H?pital ; Bangui ; République centrafricaine ; Afrique intertropicale ; Cryptococcus neoformans ; Cryptococcal neuromeningitis ; Antiretroviral treatment ; Amphotericine B ; Fluconazole ; HIV ; Hospital ; Bangui ; Central African Republic ; Sub ; Saharan Africa
• 刊名：Bulletin de la Soci篓娄t篓娄 de pathologie exotique
• 出版年：2014
• 出版时间：May 2014
• 年：2014
• 卷：107
• 期：2
• 页码：106-109
• 全文大小：103 KB
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  12. Ministère de l’Economie, du Plan et de la Coopération Internationale de la République Centrafricaine (2006). Rapport de l’enquête à indicateurs multiples couplée avec la sérologie VIH et anémie en RCA 2006. Bangui
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  16. Soumaré M, Seydi M, Ndour CT, et al (2005) Les méningites à liquide clair chez les patients infectés par le VIH à Dakar. Bull Soc Pathol Exot 98(2):119-21 [http://www.pathexo.fr/documents/articles-bull/T98-2-2728-4p.pdf]
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• 作者单位：E. Gbangba-Ngai (1)
  V. Fikouma (2)
  C. D. Mossoro-Kpinde (3)
  G. Tekpa (2)
  J. O. Ouavene (1)
  D. S. A. Yangba Mongba (1)
  P. Mbelesso (2)
  
  1. Service des maladies infectieuses du service de santé des armées, BP 430, Bangui, République centrafricaine
  2. H?pital de l’Amitié, BP 2166, Bangui, République centrafricaine
  3. Laboratoire national de biologie clinique et de santé publique, BP 1426, Bangui, République centrafricaine
  
• ISSN：1961-9049

文摘

The cryptococcal neuromeningitis is the most common fungal meningitis infections in the course of HIV/AIDS. This is the number two of opportunist infection of the central nervous system. The authors post the outcomes of a retrospective study conducted related to 122 cases of cryptococcal neuromeningitis observed over for four years ago, in Bangui in the Central African Republic, this at time when antiretroviral treatment has been avaible, corresponding to a prevalence of 6.5%. These infections very aften occur more in female folk, and to patients whose average age is 35 years old, ranging from 18 to 69 years old. The clinical symptoms often found had been headache (98,3.%), fever (95.0%), the impairing of the overall condition of the patient (86.7%) and neck stiffness (85.9%). It makes sense to notice that comorbidity case alowgwith tuberculosis, intestinal candidiasis, bacterial pneumonia and Kaposi’s diseases were found out. The screening of the cerebrospinal fluid showed a sound cell count and even low count in 12.2% of cases. Direct examination of cerebrospinal fluid with India ink helps in diagnosis of 97.5% of cases, and the culture carried out from 74 patients was in any case positive. This culture allowed the diagnosis of three patients whose examination along side with India ink has been negative. The CD4 cell count was less than 100/mm3 in 97.7% of cases. The rate of the fatality cases has been 66.4%, it has been badly impacted by a CD4 count <50/mm3 and the lack of antiretroviral therapy. Despite the establishment of a national antiretroviral treatment program to do influence the frequency of opportunistic infections whose cryptococcal neuromeningitis, this condition is still present although it is declining. The clinical variability of this disease requires early diagnosis to avoid delayed treatment corollary of a very high mortality as we have observed.