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[Prognosis factors in cryptococcal meningoencephalitis]
1Divisão de Neuroinfectologia e Neuroepidemiologia Universidade Federal da Bahia (UFBA), Brasil.
Insights
Cryptococcal meningoencephalitis lethality was 42.7%. Longer disease duration, impaired consciousness, and low cerebrospinal fluid (CSF) cell counts predicted higher mortality in this infectious disease study.
Area of Science:
- Infectious Diseases
- Neurology
- Epidemiology
Background:
- Cryptococcal meningoencephalitis is a serious fungal infection of the brain and meninges.
- Intrahospitalar lethality remains a significant concern in managing this condition.
Purpose of the Study:
- To identify demographic, clinical, and cerebrospinal fluid (CSF) variables associated with intrahospitalar lethality in patients diagnosed with cryptococcal meningoencephalitis.
Main Methods:
- Retrospective cohort study design.
- Data collected from patients admitted to Hospital Couto Maia (HCMaia), a reference center for infectious diseases in Bahia, Brazil, between 1972 and 1996.
Main Results:
- The overall lethality rate was 42.7%.
- Neurological abnormalities included neck stiffness, decreased consciousness, behavioral changes, cranial nerve palsy, and visual alterations.
- Disease duration exceeding 30 days, impaired consciousness, and CSF cell counts below 40/mm³ were associated with increased lethality.
Conclusions:
- Disease duration over 30 days, altered consciousness level, and decreased CSF cellularity were identified as the sole predictors of lethality.
- These findings highlight critical factors for prognosis assessment in cryptococcal meningoencephalitis.
Objective:
To identify demographic, clinical and cerebrospinal fluid (CSF) variables associated to intrahospitalar lethality of patients with cryptococcal meningoencephalitis.
Study Design:
Retrospective cohort to study prognosis.
Setting:
Hospital Couto Maia (HCMaia) reference for patients with infectious diseases in the State of Bahia Northeastern Brazil.
Population:
Patients admitted at HCMaia, from 1972 to 1996, with the diagnosis of cryptococcal meningoencephalitis.
Results:
Lethality rate was 42.7%. The most important neurological abnormalities were neck stiffness, decreased consciousness level, behavior changes, cranial nerve palsy and visual alteration. Disease time over 30 days, involvement of consciousness level and cerebrospinal fluid cells under 40/mm3 were associated to a higher lethality rate.
Conclusion:
Disease time over 30 days, involvement of consciousness level, and CSF decreased cellularity were the only predictors of lethality in the studied population.