[Cryptococcal meningitis in children: description of 3 cases]

Med Trop (Mars). 2011 Apr;71(2):176-8.
[Article in French]

Abstract

Cryptococcal meningitis is much less common in children than adults. The purpose of this report is to describe 3 cases of cryptococcal meningitis observed in children admitted to the Neurology Department of the Fann University Hospital Center in Dakar, Senegal between July 2003 and November 2008. There were 2 girls whose ages were 8 and 15 years and one 9-year-old boy. All 3 patients presented acute or chronic meningoencephalitis. Diagnosis was based on direct microscopic examination of India ink preparations of cerebrospinal fluid (CSF) showing Cryptococcus neoformans at direct exam. Two patients were immunocompromised including one presenting severe protein-caloric malnutrition and one infected by HIV-1. The third patient was immunocompetent. All 3 patients were treated by intravenous Fluconazole. The immunocompetent boy died after 1 month of hospitalization due to cardiovascular and respiratory insufficiency. Both girls survived with severe neurosensory sequels. Cryptococcal meningitis that is relatively frequent in adulthood may be underestimated in children and should be tested for in any children presenting meningoencephalitis of undetermined cause.

Publication types

  • Case Reports

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis*
  • AIDS-Related Opportunistic Infections / drug therapy
  • AIDS-Related Opportunistic Infections / virology
  • Adolescent
  • Anti-HIV Agents / therapeutic use
  • Antifungal Agents / therapeutic use
  • Child
  • Cryptococcus neoformans / isolation & purification*
  • Drug Therapy, Combination
  • Fatal Outcome
  • Female
  • Fluconazole / therapeutic use
  • Follow-Up Studies
  • Humans
  • Immunocompromised Host*
  • Male
  • Malnutrition / complications
  • Meningitis, Cryptococcal / cerebrospinal fluid
  • Meningitis, Cryptococcal / diagnosis*
  • Meningitis, Cryptococcal / drug therapy
  • Meningitis, Cryptococcal / microbiology
  • Risk Factors
  • Treatment Outcome

Substances

  • Anti-HIV Agents
  • Antifungal Agents
  • Fluconazole