Continue Lumbar Drainage for Intracranial Pressure Control of HIV-Associated Cryptococcal Meningitis Patients from Low to Middle Income Area/Country Volume 5 - Issue 3

Zezhou Wu¹, He Luan¹, Jianglong Qin², Fang Xiao¹, Peiqi Wan¹ and Boming Liao¹*

• ¹Department of Infectious Diseases, 1st Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, P. R, China
• ²Department of Infectious Diseases, Nanning Infectious Hospital, Guangxi Medical University, Nanning, Guangxi, P. R. China

Received: September 15, 2020;   Published: September 24, 2020

*Corresponding author: Boming Liao, Department of Infectious diseases, 1^st Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, PR China

DOI: 10.32474/LOJMS.2020.05.000215

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Abstract

Background: The aim of this pilot study was to compare the intracranial pressure (ICP) control between the continuous lumbar drainage (CLD) and repeated lumbar puncture (LP) on the patients with HIV-associated Cryptococcal Meningitis (CM).

Methods: From January 2017 to January 2019, a total of forty patients with HIV-associated CM patients were randomized and allotted into CLD or repeated LP groups, respectively. During the first two weeks of the treatment, either CLD or LP were used to control the ICP pressure except the routine antifungal therapy was given following the consensus and guidelines of CM. The ICP pressure, protein concentration and cell count from CSF were assayed and compared between the two groups.

Result: All the patients were survived. At the day 14 post treatment, a drop in ICP was observed among patients and clinical symptoms were relieved. The ICP of CLD group was significantly lower than those of LP group(P<0.05). The protein concentration and cell count from CSF of CLD group were significantly less than LP group(P<0.05).

Conclusions: CLD is a simple, safe or the first-choice control of intracranial hypertension in the patients with HIV associate cryptococcal meningitis. Especially, for patients were treated in primary and/or secondary hospitals located at the low-middle income areas/country.

Keywords: HIV-associated; cryptococcal meningitis; continuous lumbar drainage; low-middle income; cerebral spinal fluid; intracranial pressure

Abbreviations: HIV: Human Immunodeficiency Virus; CM: Cryptococcal Meningitis; ICP: Intracranial Pressure; CLD: Continuous Lumbar Drainage; LP: Lumbar Puncture; CSF: Cerebral Spinal Fluid; ART: Antiretroviral Therapy

Abstract| Introduction| Materials and Methods| Statistical analysis| Results| Discussion| Conclusions| Acknowledgements| Funding| Conflict of interest| References|