Cryptococcal Meningitis: Outcome in Patients with AIDS and Patients with Neoplastic Disease

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Abstract
A retrospective analysis of 41 patients with cryptococcal meningitis and AIDS or neoplastic disease was done. Patients with AIDS were younger and predominantly male; they had a shorter duration ofprior illness, higher initial serum cryptococcal antigen titers, and lower initial cerebrospinal fluid white blood cell counts than those with neoplastic disease. The median overall survival for patients with AIDS was 9 months compared with 2 months for those with neoplastic disease (P = .004). Seventy-eight percent of patients with AIDS and 43% of those with neoplastic disease were cured or improved 6 months after diagnosis (P = .039). Toxicity from amphotericin Band flucytosine was similar for both groups. One patient with AIDS relapsed. Multivariate predictors ofsurvival included headache (P = .007) and an AIDS diagnosis (P = .009). Examination ofoutcomes for other opportunistic infections associated with AIDS and other immunosuppressive illnesses may distinguish prognostic features for different patient populations.

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