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Cryptococcal Meningitis
Jan 7, 2006

Friday January 06, 2006 5:30 PM

I'm at at a loss here. My partner, who has been pos for nearly 20 years now, has contracted CM (according to our ID doctor). What we don't understand is that based on "the literature" regarding this OI is that you are at risk with CD4 less than 50-100. Before he came down with this his CD4 count was over 700. His latest labs indicate a CD4 count of 500, granted a decrease from the 700 level but nowhere near the levels of <50 which the literature says you are most at risk.

Does anyone have any insight/experience?

He's been put on HIGH doses of Dolucan as a therapy and if his fevers don't tame themselves in the next day or so, our doctor instructed me to "get him to the hospital".

Response from Dr. Henry

I have seen several patients with cryptococcal meningitis with CD4 cells > 300-350 forinexplicable reasons. There are also scattered reports in the literature. For patients who have had a splenectomy the CD4 count is often artifically/misleadingly high so that issues does concern a small number of patients. KH



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