Cryptococcose neuroméningée chez des patients infectés par le VIH au Centre Hospitalier Régional d’Agadir (région Souss-Massa, Maroc)

Chadli, Smail; Aghrouch, Mohamed; Taqarort, Naima; Malmoussi, M; Ouagari, Zineb; Moustaoui, F.; Bourouache, M.; Oulkheir, Said

doi:10.1016/j.mycmed.2017.10.006

Cited by 9 publications

(10 citation statements)

References 27 publications

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“…Emergency diagnosis of NMC is based on the search for yeasts in the CSF and for circulating antigens. Direct microscopic examination is positive in 72 to 84% of cases, only its sensitivity is not as certain as that of CSF culture which varies from 94 to 100% [9,12] .…”

Section: Discussionmentioning

confidence: 93%

“…In our case, only fever, headache, behavioral disorder and meningeal syndrome were clinically found. In their study carried out in Morocco in 2017, Chadli et al [9] found no cases of seizures and damage to cranial nerves in 40 cases of NMC.…”

Section: Discussionmentioning

confidence: 94%

“…Serum screening for cryptococcal antigens generally has excellent specificity and sensitivity (> 95%). In addition, the method is simple, fast and reliable, which makes it the means of choice for the diagnosis of NMC [9] . The antigen titer reflects the fungal load, offers better monitoring of treatment [14] , and is correlated with the degree of severity of the infection [10] .…”

Section: Discussionmentioning

confidence: 99%

“…The brain scan was normal in our case. In the literature, normal brain imaging is found in 50% of cases for brain CT-scan [5,9] . Therapeutically, our patient was put on fluconazole.…”

Section: Discussionmentioning

confidence: 99%

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Cryptococcus neoformans meningitis in an immunocompetent adult: A case report

et al. 2020

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Neuromeningeal cryptococcosis (NMC) is relatively rare in immunocompetent subjects. We report a Congolese case of NMC diagnosed in an apparently immunocompetent subject. A 35-year-old woman was admitted for acute meningoencephalitis. The cerebrospinal fluid (CSF) examination revealed cytological and biochemical abnormalities and the presence of Cryptococcus neoformans on direct examination with India ink and in culture. The serum dosage of cryptococcal antigens was titrated at 1:32. HIV and syphilis antibodies were negative and the blood CD4 lymphocyte count was 610/mm3. The patient had no other immunosuppressive factors, in particular no hematologic abnormalities, no solid tumor, or malnutrition. She was unsuccessfully treated with fluconazole intraveinously, and died after 10 days of treatment. This observation reminds us that NMC can occur in subjects without apparent immunosuppressive factor with a misleading clinical presentation. It is a rare infection with a severe prognosis even in immunocompetent patients.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

“…The brain scan was normal in our case. In the literature, normal brain imaging is found in 50% of cases for brain CT-scan [5,9] . Therapeutically, our patient was put on fluconazole.…”

Section: Discussionmentioning

confidence: 99%

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Cryptococcus neoformans meningitis in an immunocompetent adult: A case report

et al. 2020

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“…In 2009, this region recorded the highest prevalence of HIV/AIDS in the country (0.9%) [10]. Since then, few studies have been carried out in the area [9, 17, 21, 23-28]; most of them were especially focused on groups that carried a high-risk (female sex workers, men who have sex with men, drug users) [9, 17, 23]. These groups were the main population studied in relation to HIV epidemic in Morocco and elsewhere in the world, with heterosexual sex-worker networks being the largest of the three kinds of high-risk groups, followed by MSM, and then IDUs [10].…”

Section: Discussionmentioning

confidence: 99%

The prevalence of syphilis in HIV-seropositive patients: a retrospective study at the regional hospital in Agadir, Morocco

et al. 2019

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IntroductionHIV and syphilis are major public health problems in Morocco. The region of Souss-Massa, south-west of the country, hold more than 24% of HIV seropositive cases registered in Morocco during 2009. The aim of this study is to evaluate the seroprevalence of syphilis among HIV seropositive patients in the region of Souss-Massa, south-west of Morocco.MethodsTo evaluate the seroprevalence of syphilis and neurosyphilis among HIV seropositive patients, we retrospectively investigated the medical records of HIV-infected patients attending the regional hospital located in the city of Agadir, during the period comprised between 2011 and 2016.ResultsThe population studied involved 1381 males (49.18%) and 1427 females (50.82%) HIV seropositive patients. Among them, 481 patients were seropositive for syphilis and three cases were diagnosed with neurosyphilis. The sex ratio distribution was 243 male (52.71%) and 218 female (47.29%). The prevalence of syphilis among the studied population was estimated to 16.42% with a slight dominance in male (17.63%) compared to female (15.28%). By contrast, neurosyphilis was only detected in male patients, with a prevalence estimated to 0.11%.ConclusionEven if the prevalence of HIV and syphilis is stable in the region of Souss-Massa, the prevalence of syphilis among HIV seropositive patients remained high and correlated positively with that of HIV infection. We did not find a significant difference between the genders, in relation to the prevalence of HIV and syphilis. We concluded that it was essential to continue monitoring the population, in order to improve the prevention and the access to the medical care in the south-west of Morocco.

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