Clinical Aspects of Cryptococcosis in Patients with AIDS

Cryptococcosis, generally presenting as meningitis, is the most life threatening fungal infection in patients with AIDS. Its prevalence varies from 5% in Western Europe to 20% in Tropical Africa. Besides this dramatically increased frequency, cryptococcosis in AIDS patients differs in several respects from the mycosis as observed in non-AIDS patients. The paucity of meningeal signs and the low cell count and protein level in the cerebrospinal fluid tend to delay the diagnosis. A high index of suspicion and systematic screening of all suspected HIV positive patients for serum cryptococcal antigen may detect the disease at an earlier stage and improve survival.