Abstract
This retrospective study aimed to evaluate the clinical, laboratory, and quantitative cerebrospinal fluid (CSF) cryptococcal cell counts for associations with in-hospital outcomes of HIV-infected patients with cryptococcal meningitis. Ninety-eight HIV-infected adult patients with CSF culture-proven cryptococcal meningitis were admitted between January 2006 and June 2008 at a referral center in Sao Paulo, Brazil. Cryptococcal meningitis was the first AIDS-defining illness in 69%, of whom 97% (95/98) had known prior HIV infection. The median CD4+ T-cell count was 39 cells/μL (interquartile range 17-87 cells/μL). Prior antiretroviral therapy was reported in 50%. Failure to sterilize the CSF by 7-14 days was associated with baseline fungal burden of ≥ 10 yeasts/μL by quantitative CSF microscopy (odds ratio [OR] = 15.3, 95% confidence interval [CI] 4.1-56.7; P < 0.001) and positive blood cultures (OR = 11.5, 95% CI 1.2-109; P = 0.034). At 7-14 days, ≥ 10 yeasts/μL CSF was associated with positive CSF cultures in 98% versus 36% with <10 yeasts/μL CSF (P < 0.001). In-hospital mortality was 30% and was associated with symptoms duration for >14 days, altered mental status (P < 0.001), CSF white blood cell counts <5 cells/μL (P = 0.027),...Continue Reading
References
Mar 11, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Sara A MirzaRana A Hajjeh
May 16, 2006·Revista Da Sociedade Brasileira De Medicina Tropical·Jacqueline Ferreira de OliveiraRodrigo Corrêa Oliveira
Sep 25, 2007·AIDS·Dirceu B Greco, Mariangela Simão
Aug 28, 2007·AIDS·Mara C S M PappalardoMarcia S C Melhem
Dec 20, 2007·AIDS·Joseph N Jarvis, Thomas S Harrison
Apr 25, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Andrew KambuguDavid R Boulware
May 20, 2008·Revista Do Instituto De Medicina Tropical De São Paulo·Andrea de Siqueira Campos LindenbergBodo Wanke
Sep 25, 2008·Revista Do Instituto De Medicina Tropical De São Paulo·José E VidalJ Roberto Trujillo
Nov 8, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Nicky LongleyThomas S Harrison
Jan 27, 2009·Revista de saúde pública·Nicolas DegallierChristophe Menkes
Feb 3, 2009·AIDS·Benjamin J ParkTom M Chiller
Feb 26, 2009·AIDS·Thomas S Harrison
Mar 13, 2009·AIDS·Tihana BicanicThomas Harrison
Jun 24, 2009·Memórias do Instituto Oswaldo Cruz·Marli PradoCarlos P Taborda
Jul 21, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Tihana BicanicThomas S Harrison
Sep 23, 2009·AIDS·A Rizal GaniemReinout van Crevel
Mar 17, 2010·BMC Infectious Diseases·Joseph N JarvisThomas S Harrison
Citations
Oct 15, 2013·Infection·L de VediaR Prieto
May 15, 2013·The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases·Jose E VidalDavid R Boulware
Oct 25, 2016·Tropical Medicine & International Health : TM & IH·José E VidalDavid R Boulware
Oct 31, 2015·Journal of Neurosurgery·Jacob CherianShankar P Gopinath
Dec 13, 2016·Expert Review of Molecular Diagnostics·Matthew William McCarthy, Thomas J Walsh
Oct 16, 2015·Revista Do Instituto De Medicina Tropical De São Paulo·Jose E Vidal, David R Boulware
Mar 2, 2016·The American Journal of Tropical Medicine and Hygiene·Erika NascimentoRoberto Martinez
Jul 26, 2019·PloS One·Moara Alves Santa Bárbara BorgesMarília Dalva Turchi
Jan 13, 2015·Clinical Chemistry and Laboratory Medicine : CCLM·Daniel Morell-GarciaIsabel Llompart
May 3, 2018·BMC Neurology·Jia LiuFu-Hua Peng
Jan 24, 2020·BMC Infectious Diseases·Chen ZhangFafa Tian
Jun 22, 2014·Mycopathologia·Renata Buccheri de OliveiraDaniel Wagner de Castro Lima Santos
Sep 15, 2017·Journal of the Pediatric Infectious Diseases Society·Matthew W McCarthyThomas J Walsh
Apr 12, 2018·Memórias do Instituto Oswaldo Cruz·Carolina FiracativeUNKNOWN Latin American Cryptococcal Study Group
Apr 19, 2020·BMC Neurology·James J M LoanA Graham Fieggen
Apr 20, 2021·The Lancet Infectious Diseases·Katharine Elizabeth StottWilliam Hope
Dec 2, 2020·Mycopathologia·José E VidalAugusto C Penalva de Oliveira