Dear Dr. Feinberg,

My husband was suffering from severe headaches in early November in 1981. He was admitted to hospital and after numerous test was diagnosed with crypto-coccal meningitis on the 30th December. As we live in South Africa, a very toxic medicine was flown in from the States. At that point very few doctors knew about this disease. He had two brain drains and the doctors were perplexed because his immune system has collapsed. He went downhill so fast. Loosing his sight, hearing and was paralyzed. He died in the middle of February. My question is this - did he have Aids? Did this lead to his death? Remember this was November 1980 when he went to hospital. What is the connection between crypto-coccoal meningitis and Aids?

It is highly likely that your husband did have AIDS. Cryptococcal meningitis is one of the opportunistic infections that plague HIV+ people who have advanced disease, and it occurs because their immune system can no longer protect them from common germs in the environment that rarely trouble healthy people. Cryptococcal meningitis is indeed one of the OIs that defines what is called the "case definition" of AIDS. It sounds like he died of severe meningitis, because he had increased pressure in his brain due to the infection (that's what the drains were for -- to relieve pressure) and because the crucial nerves to his eyes and ears were affected as well. If you have never been tested for HIV, you should do so just in case, although if you have been healthy in the intervening 20 years the odds that you are HIV+ are very remote.