CSF Pressure in HIV-Infected Patients with Cryptococcal Meningitis

CSF pressure was elevated in 63% of such patients.

Raised cerebrospinal fluid (CSF) pressure in HIV-infected patients with cryptococcal meningitis (CM) may lead to neurological complications and poor clinical outcomes. What factors contribute to elevated pressure, and how effective is serial lumbar puncture (LP) with CSF drainage in lowering it? To find out, investigators evaluated 163 HIV-infected antiretroviral-naive patients with CM who enrolled in trials of amphotericin-based treatment in Thailand and South Africa.

Participants underwent LPs for quantitative CSF cultures on days 1, 3, 7, and 14 of therapy. Additional LPs with CSF drainage were performed for patients with opening pressures (OPs) >35 cm H₂O or symptoms of increased pressure.

The median OP was 23 cm H₂O; 63% of patients had …

Reviewing Author

Rajesh T. Gandhi, MD

Disclosures

Grant/Research SupportNIH

Editorial BoardsUpToDate; ID Images (idimages.org); Infectious Diseases Society of America COVID-19 Treatment Guidelines; International Antiviral Society–USA (Guidelines Committee)

Leadership Positions in Professional SocietiesHIV Medicine Association; Infectious Diseases Society of America (Board of Directors)

Rajesh T. Gandhi, MD

Disclosures

Grant/Research SupportNIH

Editorial BoardsUpToDate; ID Images (idimages.org); Infectious Diseases Society of America COVID-19 Treatment Guidelines; International Antiviral Society–USA (Guidelines Committee)

Leadership Positions in Professional SocietiesHIV Medicine Association; Infectious Diseases Society of America (Board of Directors)

CSF Pressure in HIV-Infected Patients with Cryptococcal Meningitis

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Reviewing Author