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Cryptococcosis in HIV-negative Patients with Renal Dialysis: A Retrospective Analysis of Pooled Cases

Nan Hong1, Min Chen1, Wenjie Fang1

  • 1Shanghai Key Laboratory of Molecular Medical Mycology, Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.

Mycopathologia
|July 2, 2017
PubMed

Insights

Cryptococcosis in HIV-negative dialysis patients is poorly understood. This study highlights non-neoformans/gattii species and suggests considering cryptococcosis even with negative antigen tests, emphasizing catheter removal and optimized antifungal strategies.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Nephrology

Background:

  • Cryptococcosis, a serious fungal infection, is primarily caused by Cryptococcus neoformans/C. gattii.
  • Data on cryptococcosis in HIV-negative patients undergoing renal dialysis is limited.
  • Understanding this infection in dialysis patients is crucial for timely diagnosis and treatment.

Purpose of the Study:

  • To systematically review the epidemiology and clinical features of cryptococcosis in HIV-negative patients on renal dialysis.
  • To pool data from multiple sources to increase statistical power and provide a comprehensive overview.
  • To identify specific challenges and recommendations for managing cryptococcosis in this vulnerable population.

Main Methods:

  • A pooled analysis of 18 cases from the authors' hospital and four medical databases.
  • Analysis of epidemiological data, including dialysis modality and duration.
  • Review of clinical manifestations and causative fungal species.

Main Results:

  • The median dialysis duration was 8 months for peritoneal dialysis and 36 months for hemodialysis.
  • Non-neoformans/gattii species, such as Cryptococcus laurentii and Cryptococcus albidus, were identified.
  • Clinical presentations of these non-neoformans/gattii species were similar to those of C. neoformans and C. gattii.

Conclusions:

  • Physicians should suspect cryptococcosis in renal dialysis patients, even with negative cryptococcal antigen tests.
  • Prompt catheter removal is vital for peritoneal dialysis patients diagnosed with cryptococcosis.
  • Optimized antifungal treatment strategies are needed for renal dialysis recipients with cryptococcal infections.
Keywords:
CryptococcosisPooled analysisRenal dialysis

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