Obstructive Hydrocephalus Secondary to Cryptococcal Meningitis in an Immunocompetent Adult

Seetahal-Maraj, Panduranga; Giddings, Stanley; Ramcharan, Kanterpersad; Ramnarine, Narindra

doi:10.7759/cureus.18975

Cited by 2 publications

(5 citation statements)

References 12 publications

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“…Of the 46 studies included, 20 were cohorts 4 , 10 , 14 – 18 , 21 – 33 and 26 were case reports/series. 12 , 34 – 58 The cohort studies were divided in 7 two-arm (groups with and without shunt) and 13 one-arm (group with shunt) studies, and their characteristics are summarized in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

Cerebrospinal fluid shunting for the management of cryptococcal meningitis: a scoping review

Cornejo-Venegas,

Carreras,

Salcedo

et al. 2024

Therapeutic Advances in Infection

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Objective: This scoping review aimed to describe studies that evaluate the management of cryptococcal meningitis (CM) using cerebrospinal fluid (CSF) shunts, types of shunts used, and clinically relevant patient outcomes. Methods: We searched in the following databases: PubMed, Web of Science/Core collection, Embase, the Cochrane Library, and clinicaltrials.gov on 1 April 2022. We included two-arm and one-arm cohort studies that evaluated clinically relevant patient outcomes. Case reports were used to describe the type of CSF shunts used and the rationale behind its selection. The selection and extraction processes were independently performed by two authors. Results: This study included 20 cohort studies and 26 case reports. Only seven cohort studies compared two groups. Ventriculoperitoneal shunt was the most commonly used type of shunt (82.1%). The main indications for placing a shunt were persistently high opening pressure (57.1%) and persisting neurological symptoms or deterioration (54.3%). Cohort studies suggest that patients with shunt showed improvement in some outcomes such as neurological symptoms and hospital stay length. The most common shunt complications were post-operative fever (1–35.6%) and shunt obstruction (7–16%). Conclusion: CSF shunts may improve some clinically relevant outcomes in patients with CM, but the evidence is very uncertain.

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Section: Resultsmentioning

confidence: 99%

Cerebrospinal fluid shunting for the management of cryptococcal meningitis: a scoping review

Cornejo-Venegas,

Carreras,

Salcedo

et al. 2024

Therapeutic Advances in Infection

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Section: Discussionmentioning

confidence: 99%

“…CM is a common opportunistic infection in immunocompromised hosts and the leading cause of meningoencephalitis in sub-Saharan Africa and Southeast Asia [ 5 , 6 ]. It typically affects the respiratory tract and then disseminates hematogenously to the brain [ 6 ]. To date, even with effective pathogen-directed therapy and the widespread use of highly active antiretroviral therapy (HAART), CM is still a refractory disease with a long course and poor prognosis [ 5 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…While the choice of treatment and the timing are subject to controversy, many authors recommend that the shunt placement should be performed within an appropriate timeframe to avoid long-term complications from CM [ 2 , 8 ]. However, some cases of hydrocephalus secondary to CM do not improve after CSF diversion through a VP shunt, which suggests that selecting the right patients for this procedure is important [ 6 , 8 ]. The selection criteria for VP shunting are not well established, but several factors contributing to this decision are reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…These include extremely high ICP with or without hydrocephalus, increased opening pressure with severe clinical signs of ICH, a favorable response to large volume removal of CSF via lumbar puncture but requiring continuous lumbar CSF drainage to remain neurologically asymptomatic, the presence of papilledema with potential vision loss, symptom recurrence despite maximal antifungal therapy, and radiological findings such as meningeal enhancement, single or multiple nodules, cerebral edema, or hydrocephalus [4,[9][10][11]. The timing of the surgery according to Tang is dependent on the patient's symptoms, as the presence of acute signs and symptoms of hydrocephalus are factors predictive of a better outcome after shunt placement [6,12]. On the other hand, some authors suggest prophylactic shunt placement to avoid irreversible neurological complications [8,11].…”

Section: Discussionmentioning

confidence: 99%

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Subacute Hydrocephalus Revealing a Cryptococcus Infection in a Seven-Year-Old Child

Belokda,

Hamadi,

Ait M'Barek

et al. 2024

Cureus

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Cryptococcal meningitis (CM) is the third most common neurological complication in immunocompromised patients and is usually associated with high rates of morbidity and mortality. The most common complication of CM is intracranial hypertension (ICH), and it constitutes a poor prognosis factor. This case report describes a case of subacute onset hydrocephalus revealing a human immunodeficiency virus (HIV)-associated CM in a seven-year-old girl requiring cerebrospinal fluid diversion and fungal treatment with a favorable outcome.

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Obstructive Hydrocephalus Secondary to Cryptococcal Meningitis in an Immunocompetent Adult

Cited by 2 publications

References 12 publications

Cerebrospinal fluid shunting for the management of cryptococcal meningitis: a scoping review

Cerebrospinal fluid shunting for the management of cryptococcal meningitis: a scoping review

Subacute Hydrocephalus Revealing a Cryptococcus Infection in a Seven-Year-Old Child

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