Table 1.
Demographics and Baseline Characteristics
| Characteristic | Initial CM | Prior CM | TBM (Definite or Probable) | Other | Overall | P Value |
|---|---|---|---|---|---|---|
| No. | 509 | 78 | 52 | 203 | 842 | |
| Male | 303 (60) | 40 (51) | 34 (65) | 100 (49) | 477 (57) | .03 |
| Age, y | 35 [29–40] | 34 [29–42] | 32 [30–40] | 37 [30–44] | 35 [30–42] | .16 |
| Receiving ART | 244 (48) | 73 (94) | 32 (62) | 111 (55) | 460 (55) | <.001 |
| Months on ART | 6 [1–35] | 8 [2–37] | 7 [3–22] | 15 [3–57] | 9 [1–36] | .01 |
| Clinical presentation | ||||||
| Fever | 260 (51) | 18 (23) | 45 (87) | 133 (66) | 456 (54) | <.001 |
| Headache | 493 (97) | 76 (97) | 50 (96) | 175 (86) | 794 (94) | <.001 |
| Duration of headache | 14 [7–28] | 14 [7–30] | 9 [7–14] | 10 [6–14] | 14 [7–21] | <.001 |
| Photophobia | 131 (26) | 20 (26) | 9 (17) | 24 (12) | 184 (22) | <.001 |
| Visual change | 149 (29) | 30 (38) | 15 (29) | 41 (20) | 235 (28) | .01 |
| Glasgow Coma Score <15 | 255 (50) | 22 (28) | 47 (90) | 145 (71) | 469 (56) | <.001 |
| Seizure | 87 (17) | 9 (12) | 6 (12) | 26 (13) | 128 (15) | .30 |
| Laboratory parameters | ||||||
| CD4 count per μL | 16 [6–43] | 27 [6–77] | 85 [47–131] | 73 [22–242] | 26 [7–76] | <.001 |
| CSF opening pressure, cm H2Oa | 26 [18–38] | 29 [18–43] | 21 [9–36] | 14 [10–20] | 25 [17–38] | <.001 |
| CSF OP <20 cm H20 | 139 (32) | 17 (28) | 6 (43) | 38 (76) | 200 (36) | <.001 |
| CSF white cells/ μL | <5 [<5–40] | <5 [<5–65] | 60 [12–140] | <5 [<5–5] | <5 [<5–40] | <.001 |
| CSF white cells <5 μL | 306 (63) | 37 (51) | 9 (20) | 125 (74) | 477 (62) | <.001 |
| CSF protein, mg/dL | 43 [23–100] | 52 [24–100] | 135 [47–280] | 45 [22–93] | 47 [23–107] | <.001 |
| CSF protein <45 mg/dL | 213 (51) | 31 (50) | 10 (23) | 70 (50) | 324 (49) | <.01 |
| Normal WBC + proteinb | 182 (44) | 23 (37) | 4 (10) | 63 (45) | 272 (41) | <.001 |
Table 1 presents the demographics and baseline clinical and laboratory characteristics of 842 Ugandan adults with HIV presenting with suspected meningitis. Patients with cryptococcal meningitis were overall more likely to be ART experienced and had lower median baseline CD4 counts. Data are presented as follows: No. (%) for categorical variables, median [IQR] for continuous variables. P values are from chi-square tests for categorical variables and Kruskal-Wallis tests for continuous variables. Among those with empiric TB diagnoses, 32 participants had both CSF protein (n = 32) and white cell count (n = 47). Among patients with cryptococcal meningitis, 3 were diagnosed with concurrent definite TB meningitis. One symptomatic cryptococcal antigenemia person was diagnosed with probable TB meningitis. One person with definite TB meningitis by Mycobacteria Growth Inhibitor Tube culture and 1 person with probable TB meningitis both had a history of cryptococcal meningitis, being CSF CrAg positive and fungal culture negative.
Abbreviations: ART, antiretroviral therapy; CM, cryptococcal meningitis; CSF, cerebrospinal fluid; IQR, interquartile range; OP, Opening Pressure; TB, tuberculosis; TBM, tuberculous meningitis; WBC, white blood cell.
aCSF opening pressure was not measured routinely in noncryptococcal patients (n = 19 with TB meningitis, n = 1 with empiric TB meningitis therapy).
bCSF WBC <5 µL and protein <45 mg/dL.