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Year : 1995  |  Volume : 13  |  Issue : 2  |  Page : 65-69

Cryptococcosis in and around Chandigarh : an analysis of 65 cases


Department of Medical Microbiology Internal Medicine, Nephrology and Neurology, Post graduate Institute of Medical Institute and Research, Chandigarh 160 012

Correspondence Address:
A Chakrabarti
Department of Medical Microbiology Internal Medicine, Nephrology and Neurology, Post graduate Institute of Medical Institute and Research, Chandigarh 160 012

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ABSTRACT: Cryptococcus species was isolated and/or cryptococcal antigen detected 65 patients in Nehru Hospital, Chandigarh during 1983-1994. Eleven patients had subclinical infection or carrier state of lung which subsided without therapy. In the 54 cases with clinical disease, the diagnosis was made by both culture and cryptococcal antigen detection in 37, cryptococcal antigen detection alone in 11 and by isolation alone in 6 cases. Cryptococcus was isolated from cerebrospinal fluid (CSF), blood and urine in 86.0, 37.2, and 14.0 percent of patients respectively. All except three isolates were identified as Cryptococcus neoformans. The three other isolates were found in the sputum in the subclinical group, two were C.albidus and one C.laurentii. Predisposing factors were identified in 57.4 percent of patients with clinical infection, of which renal transplantation was the commonest. Use of combination therapy of amphotericin B and 5-fluorocytosine was more effective than amphotericin B alone. Seven out eight patient treated with fluconazole responded. Latex agglutination test for detection of antigen in CSF was found to be useful both in diagnosis and in predicting the outcome of the patients as geometric mean of antigen titre in CSF was significantly higher (p0.001) in patients who died compared to those who recovered.






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