BACKGROUND: Cryptococcal meningitis is a severe fungal infection of the central nervous system associated with significant morbidity and mortality among people living with HIV/AIDS (PLWHA). This study aims at determining the prevalence, epidemiological characteristics, clinical features, neuroimaging, laboratory findings, and treatment, among PLWHA having CM and identifying early predictors of outcome.

CASE PRESENTATION: We retrospectively analyzed data from 11 PLWHA with CM hospitalized in Setif hospital from January 1985 to May 2022. Eight men (72.7%) and three women (27.3%) were involved in the study; the median age was 39.27 years (range: 18-69 years); clinical manifestations included headache (9, 81.8%), fever (7, 63.6%), restless (6, 54.5%), seizure (3, 27.3%), meningeal syndrome (5, 45.5%); CD4 count ≤ 50 cells/mm3 was detected in 6 patients (54.5%), 7 patients (63.6%) showed normal cerebrospinal fluid cell counts and 9 (81.8%) had a normal biochemical examination; 3 patients (27.3%) had abnormalities shown on intracranial imaging; 11 cases (100%) were culture positive, 10 (90.9%) were positive by India ink preparation, and in-hospital mortality was detected in 7 patients (63.6%).

CONCLUSIONS: The study reports a low prevalence of CM among PLWHA attending our hospital and a high mortality despite the administration of Amphotericin b deoxycholate or Fluconazole. Factors as late presentation of patients, the lack of CrAg screening and the absence of Flucytosine may have contributed to the poor outcome.