India Ink Staining, a Rapid and Affordable Test for Diagnosis of Cryptococcal Meningitis
ABSTRACT: Cryptococcal
meningitis incidence has increased along with an increase in incidence of
HIV-AIDS. This infection causes increased morbidity and mortality in patients
with HIV-AIDS. A rapid diagnosis plays an important role to ensure a prompt
therapy of the disease. The cryptococcal polysaccharide antigen test for
diagnosis of meningitis is rapid but relatively expensive while culture is time
consuming. A 47-year man was admitted to hospital with a headache, fever,
nausea, and vomiting and a HIV history for the last 6 months. On physical
examination, he was compos mentis, meningeal’s stimuli signs (+), where as on
examination of craniales nerves, motor and sensibility was in a normal range.
Routine blood was normal, 60 CD4 cells/mm3. Laboratory finding included a
clowdy/turbid Cerebrospinal fluid (CSF), low glucose level (CSF glucose 43 mg /dl
vs. blood glucose 293 mg / dl), elevated protein concentration (137.1 mg / dl),
and polymorphonuclear pleocytosis. India ink stain showed encapsulated yeasts. Cryptococcus
sp is the only encapsulated yeast, while C. neoformans is the most common cause
of Cryptococcosis in patients with HIV-AIDS. The patient was diagnosed with
Cryptococcal meningitis by indian ink staining, and immediately given
anti-fungal theraphy.
Author: Masfiyah
Journal Code: jpkedokterangg150298
