Cryptococcal meningitis in human immunodeficiency virus-infected patients in Harare, Zimbabwe

Clin Infect Dis. 1998 Feb;26(2):284-9. doi: 10.1086/516298.


A prospective observational study was conducted over a 10-month period to determine the clinical and laboratory manifestations of cryptococcal meningitis in Zimbabwe, a country where antifungal agents are not widely available. Eighty-nine patients with cryptococcal meningitis (median age, 34 years; range, 11-63 years; 56 males) were identified from 406 patients for whom a clinical diagnosis of meningitis had been made. All patients tested were positive for antibody to human immunodeficiency virus. Cryptococcal meningitis was the first AIDS-defining illness in 88% of patients. Typical presentations were headache, mental impairment, and meningism (median duration, 14 days; range, 1-180 days). The median CD4+ cell count was 70/microL (range, 0-651/microL). The cumulative median survival from the time of diagnosis was 14 days (range, 0-233 days); 22% of patients survived for >30 days. Independent indicators of a good prognosis were not identified. This study provides a unique basis for the development of novel management strategies for patients with cryptococcal meningitis who reside in resource-poor countries.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / physiopathology
  • AIDS-Related Opportunistic Infections / therapy*
  • Adolescent
  • Adult
  • Child
  • Cryptococcosis / complications
  • Cryptococcosis / physiopathology
  • Cryptococcosis / therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Meningitis, Fungal / complications
  • Meningitis, Fungal / physiopathology
  • Meningitis, Fungal / therapy*
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome
  • Zimbabwe