The diagonostic value of Serum Cryptococcal Antigen Titres among HIV infected patients with suspected cryptococcal meningo-encephalitis attending Mulago Hospital

Abstract

Cryptococcal meningoencephalitis(CM) is the commonest, most important and most serious opportunisitc infection of the central nervous system (CNS) among HIV-AIDS Patients.The clinical presentation of CM is often non-specific with many of the symptoms similar to those of other opportunisitc infections. Much as the lumbar puncture is necessary in order to reach a diagnosis of CM.Many patents are unwilling to undergo this invasive procedure even after counselling. Society assosciates Lumbar puncture with definite mortality though this maay not be entirely right(Personal observation). CM is routinely diagonosed by India ink staining and confirmed by CSF culture. This requires adquate facilities and well trained laboratory technologists. Serum cryptococcal antigen(CRAG) test has been found to be a useful, simple, less invasive and less unconfortable test for diagonosis of CM. However, its clinical diagonostic value has not been well investigated in Uganda. The CRAG test protocol is clear, easy to follow and requires only a small volume of the serum sample. The aim of this study was to determine the diagnostic value of quantitative serum CRAG titres in the diagonosis of CM among adult HIV-Infected patients.