Comparisons of clinical features and mortality of cryptococcal meningitis between patients with and without human immunodeficiency virus infection

Abstract

The clinical features of cryptococcal meningitis between HIV and non-HIV patients have some divergences, including age, sex, underlying diseases, CSF parameters, extraneural site involvement, fungemia, and so on. We also identified risk factors for mortality of this disease. However, the mortality of cryptococcal meningitis was not different in HIV-positive and HIV-negative patients in terms of Day 30 and Day 90 mortality.

CNS–Immune Reconstitution Inflammatory Syndrome in the Setting of HIV Infection, Part 1: Overview and Discussion of Progressive Multifocal Leukoencephalopathy–Immune Reconstitution Inflammatory Syndrome and Cryptococcal–Immune Reconstitution Inflammatory Syndrome

“…Several studies have shown significant percentages of patients in whom the MR imaging or CT findings were negative in cryptococcal meningitis. 98 In fact, a recent article has shown that DTI may be a useful tool in CM because it can detect changes that may be more widespread than anticipated from conventional MR imaging. 99 Investigating the neuropsychological sequelae in HIV-negative patients with cryptococcal meningitis and its correlation to microstructural changes in the white matter, these authors found that higher CSF cryptococcal antigen levels were associated with poorer DTI parameters, with increasing ADC values and decreasing fractional anisotropy values and worse cognitive performance.…”

Infecciones en pacientes reumatológicos asociadas a corticosteroides y antagonistas del factor de necrosis tumoral α

“…La tasa de recaídas por este agente en infecciones del SNC aumenta si no se reduce la dosis de prednisona bajo el umbral inmunosupresor. Las infecciones del SNC por C. neoformans se presentan como cuadros de cefalea, compromiso de conciencia y cambios conductuales asociados a pleocitosis mononuclear y proteinorraquia moderadas, Infectología al Día sin hipoglucorraquia y frecuentemente, alteraciones en el estudio de imágenes del SNC 38,39 . El cultivo es casi siempre positivo (98%) pero de lenta obtención y el test de la tinta China sólo positivo en 50% de los casos.…”

“…La detección de antígeno de C. neoformans es de muy alta sensibilidad y rápido tiempo de respuesta 39 . El cuadro suele ser de curso indolente, sin signos meníngeos y de mal pronóstico (mortalidad global aproximada: 30%) 38,39 .…”

Cryptococcosis in Anti-Interferon-Gamma Autoantibody-Positive Patients: a Different Clinical Manifestation from HIV-Infected Patients

“…The clinical characteristics of cryptococcosis among HIV-infected and non-HIV-infected patients have been compared (7)(8)(9). Central nervous system (CNS) involvement, especially meningitis, occurs more frequently in HIV-positive patients, whereas pulmonary involvement is more frequently observed in HIV-negative patients.…”