India Ink Staining, a Rapid and Affordable Test for Diagnosis of Cryptococcal Meningitis

Masfiyah Masfiyah*  -  Clinical Microbiology Department of Medical Faculty of Sultan Agung Islamic University Semarang, Indonesia

(*) Corresponding Author

Cryptococcal meningitis incidence has increased along with an increase in incidence of HIV-AIDS. This infection causes increased morbidity and mortality in patients with HIV-AIDS. A rapid diagnosis plays an important role to ensure a prompt therapy of the disease. The cryptococcal polysaccharide antigen test for diagnosis of meningitis is rapid but relatively expensive while culture is time consuming.
A 47-year man was admitted to hospital with a headache, fever, nausea, and vomiting and a HIV history for the last 6 months. On physical examination, he was compos mentis, meningeal’s stimuli signs (+), where as on examination of craniales nerves, motor and sensibility was in a normal range. Routine blood was normal, 60 CD4 cells/mm3. Laboratory finding included a clowdy/turbid Cerebrospinal fluid (CSF), low glucose level (CSF glucose 43 mg / dl vs. blood glucose 293 mg / dl), elevated protein concentration (137.1 mg / dl), and polymorphonuclear pleocytosis. India ink stain showed encapsulated yeasts.
Cryptococcus sp is the only encapsulated yeast, while C. neoformans is the most common cause of Cryptococcosis in patients with HIV-AIDS. The patient was diagnosed with Cryptococcal meningitis by indian ink staining, and immediately given anti-fungal theraphy.

Keywords: India Ink; Cryptococcal Meningitis; HIV-AIDS

  1. Bencurova, E., Mlynarcik, P. & Bhide, M. 2011. An Insight Into The Ligand–Receptor Interactions Involved Inthe Translocation Of Pathogens Across Blood–Brain Barrier Fems Immunol Med Microbiol, 63, 297-318.
  2. Fisher, F. & Cook, N. B. 2006. Fundamental Of Diagnostic Mycology, Philadelphia, Wb Saunders Company.
  3. Lortholarya, O., Poizatc, G., Zellerd, V. R., Neuvillee, S. G. N., Boibieuxf, A., Muriel Alvarezg, Dellamonicah, P. & Bottereli, F. O. 2006. Long-Term Outcome Of Aids-Associated Cryptococcosis In The Era Of Combination Antiretroviral Therapy. Aids, 20, 2183-2191.
  4. Mahon, C. R., Clehman, D. & Manuselis, G. (Eds.) 2014. Texbook Of Diagnostic Microbiology: Elsevier.
  5. Mandell, G. L., Bennett, J. E. & Dolin, R. (Eds.) 2000. Principles And Practice Of Infectious Disease, Usa: Churchill Livingstone.
  6. Mcmullan, B. J., Halliday, C., Sorrell, T. C., Judd, D., Sleiman, S., Marriott, D., Olma, T. & Chen, S. C.-A. 2012. Clinical Utility Of The Cryptococcal Antigen Lateral Flow Assay In A Diagnostic Mycology Laboratory. Plos One, 7 1-6.
  7. Murray, P. R., Baron, E. J., Jogersen, J. H., Landry, M. L. & Pfaller, M. A. (Eds.) 2007. Manual Of Clinical Microbiology, Washington Dc: Asm Press.
  8. Tille, P. M. (Ed.) 2014. Diagnostic Microbiology, Misouri: Elsevier.
  9. Tortora, G. J., Funke, B. R. & Case, C. L. 2010. Microbiology An Introduction, San Francisco, Pearson.
  10. Venkatesh, B., Scott, P. & Ziegefush, M. 2003. Cerebrospinal Fluid In Critical Illness. Critical Care And Resuscitation, 2, 42-54.
  11. Vida, J. E., Oliveira, A. C. P. D., Dauar, R. F. & Boulware, D. R. 2013. Strategies To Reduce Mortality And Morbidity Due To Aids-Related Cryptococcal Meningitis In Latin America. Braz J Infect Dis, 17.
  12. Youssef, F. G., Azab, A. M., Wasfy, M. M., Abdel-Aziz, K. M., Parker, T. M., Oun, S. A., Jobanputra, N. N. & Hajjeh, R. A. 2006. Differentiation Of Tuberculous Meningitis From Acute Bacterial Meningitis Using Simple Clinical And Laboratory Parameters. Diagnostic Microbiology & Infectious Disease, 55, 275-278.

Open Access Copyright (c) 2015 Sains Medika : Jurnal Kedokteran dan Kesehatan
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Sains Medika: Jurnal Kedokteran dan Kesehatan
is published by Fakultas Kedokteran Universitas Islam Sultan Agung Semarang, Indonesia.
Jl. Raya Kaligawe Km.4, PO BOX 1054/SM Semarang 50112
Website: https://fkunissula.ac.id/
Email: sainsmedika@unissula.ac.idsainsmedika@unissula.ac.id

ISSN: 2339-093X (Online) | 2085-1545 (Print)
DOI : 10.30659/sainsmed

This work is licensed under a Creative Commons Attribution 4.0 International License

Get a feed by atom here, RRS2 here and OAI Links here

apps