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Cryptococcal meningitis in non-HIV-infected patients
C C Shih1, Y C Chen, S C Chang
1Departments of Internal Medicine and. Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.
QJM : Monthly Journal of the Association of Physicians
|April 29, 2000
Summary
Cryptococcal meningitis in non-HIV patients is uncommon in subtropical regions. This study found lymphoma and high cryptococcal antigen levels predict mortality, with outcomes comparable to other regions.
Area of Science:
- Infectious Diseases
- Neurology
- Mycology
Background:
- Cryptococcal meningitis is rarely reported in non-HIV-infected individuals in subtropical areas.
- This study focuses on a retrospective review of such cases to understand clinical characteristics and outcomes.
Purpose of the Study:
- To analyze the clinical features, treatment outcomes, and mortality predictors of cryptococcal meningitis in immunocompetent patients in a subtropical region.
- To compare outcomes with those reported in temperate and tropical regions.
Main Methods:
- Retrospective review of 94 non-HIV patients with cryptococcal meningitis diagnosed between 1977 and 1996.
- Analysis of patient demographics, clinical presentations, underlying conditions, treatment regimens, and outcomes.
Main Results:
- Headache, vomiting, and fever were the most common initial symptoms.
- Patients with T-cell suppression experienced more acute illness and atypical presentations.
- Lymphoma, semicoma, leukocytosis, and high initial cerebrospinal fluid cryptococcal antigen titers (> /= 1:512) were significant predictors of mortality.
Conclusions:
- Outcomes for cryptococcal meningitis in this non-HIV cohort were comparable to those in other geographical regions.
- Lymphoma and elevated cryptococcal antigen titers are independent predictors of mortality, highlighting the importance of early diagnosis and management.