Abstract
Cryptococcal meningoencephalitis (CM) may present as an acute, subacute, or chronic infection. It manifests as a chronic process in over 75 % of cases, but, sometimes, it presents with a more acute onset, mostly in HIV-associated patients. Until now, there has been no study performed on the clinical features of HIV-negative CM patients with acute/subacute onset. We collected 106 HIV-negative patients diagnosed with CM in our hospital during a 15-year period, analyzed their epidemiological and clinical features, as well as the outcomes, and explored the independent prognosis factors and the factors related to the survival time among them. We found that impaired consciousness (23.4 % vs. 3.4 %, p = 0.017) was more common in CM patients with acute/subacute onset, while decreased cerebrospinal fluid (CSF) glucose (51.9 % vs. 75.9 %, p = 0.026) was less common. The ratio of CSF glucose/blood glucose [odds ratio (OR) 0.04, 95 % confidence interval (CI) 0.004–0.262, p = 0.02], impaired consciousness (OR 5.09, 95 % CI 1.477–17.522, p = 0.01), and hospitalization length (OR 0.98, 95 % CI 0.977–0.999, p = 0.04) were indicated to be not only independent prognosis factors in HIV-negative CM patients with acute/subacute onset, but also factors significantly related to the survival time. The results of our study demonstrated that the contact history and potential history risk factors would not affect the onset process of HIV-negative CM patients, and the mortality, hospitalization length, and survival time has not been related to the onset process. However, the ratio of CSF glucose/blood glucose, consciousness level, and hospitalization length of the HIV-negative CM patients with acute/subacute onset should be of greater focus in the clinical work.
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Abbreviations
- CM:
-
Cryptococcal meningoencephalitis
- CNS:
-
Central nervous system
- CSF:
-
Cerebrospinal fluid
- SLE:
-
Systemic lupus erythematosus
- AmBd:
-
Amphotericin B deoxycholate
- 5-FC:
-
5-Fluorocytosine
- FCZ:
-
Fluconazole
- OR:
-
Odds ratio
- CI:
-
Confidence interval
- SD:
-
Standard deviation
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A very special thank you is given to Tejash Patel (University of North Carolina, USA) for the contribution to the language of this article.
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LZ conceived the design for this study and HZ drafted the manuscript. LZ revised the manuscript in detail. HZ, QC, and ZSX collected the data. HZ and DMW performed the statistical analysis. MYL, YM, XMZ, JYL, and NFC made significant contributions to this work by providing assistance and helped in the data collection, data handling, and analysis. All authors read and approved the final manuscript.
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Zheng, H., Chen, Q., Xie, Z. et al. A retrospective research of HIV-negative cryptococcal meningoencephalitis patients with acute/subacute onset. Eur J Clin Microbiol Infect Dis 35, 299–303 (2016). https://doi.org/10.1007/s10096-015-2545-0
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DOI: https://doi.org/10.1007/s10096-015-2545-0