Clear-fluid meningitis in HIV-infected patients in Dakar

This retrospective study was carried out to describe the epidemiological, clinical and aetiological aspects of clear-fluid meningitis among HIV-positive patients admitted at the Infectious Diseases Clinic in Fann Teaching Hospital in Dakar Data were collected for analysis from patients files recorded from January 1, 2001 to December 31, 2003. Forty-six cases of clear-fluid meningitis were found among HIV-infected patients, representing 51.7% of cerebro-meningeal diseases and 92% of meningitis encountered in those patients. Sex ratio MIF was 1.5 and the mean age of patients was 40.7 years [range 23-61 years]. Clinical presentations comprised headache (80%), fever (67%), meningeal syndrome (74%), coma (28%), convulsions (9%), focal neurological deficits (11%), cranial nerves dysfunction (9%). Aetiologies were represented by neuromeningeal cryptococcosis (29 cases) and tuberculous meningitis (5 cases). In 26% of cases no aetiology was found. The case fatality rate was 63% overall (29 deaths) and 83.3% among cases with unknown aetiology. It did not vary significantly according to epidemiological and clinical variables studied. Neurological sequelae were found in 4 patients who recovered. A better management of clear-fluid meningitis among HIV-positive patients should benefit from the reinforcement of our diagnostic capacities, the availability of effective systemic antifungal drugs and the prevention of opportunistic infections in the course of HIV/AIDS infection.