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Comparison of features and outcomes between HIV-negative patients with Cryptococcus gattii meningitis and

Xiao-Hong Su1, Wei-Peng Li2, Jun-Yu Liu1

  • 1Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.

Mycoses
|July 6, 2022
PubMed
Abstract

Insights

Cryptococcus gattii meningitis (CGM) and Cryptococcus neoformans meningitis (CNM) present differently in patients. Identifying the fungal species aids in guiding therapy and predicting patient outcomes for meningitis.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Neurology

Background:

  • Cryptococcus gattii meningitis (CGM) and Cryptococcus neoformans meningitis (CNM) are serious fungal infections.
  • Distinguishing between these two types of meningitis is crucial for effective treatment.

Purpose of the Study:

  • To compare the epidemiological, clinical, laboratory, and imaging features, and outcomes of CGM and CNM in HIV-negative patients.
  • To highlight the importance of species identification in guiding meningitis therapy and predicting outcomes.

Main Methods:

  • Retrospective study of HIV-negative patients diagnosed with CGM or CNM between 2015 and 2021.
  • Species identification was performed using metagenomic next-generation sequencing of cerebrospinal fluid samples.
  • Comparison of clinical, laboratory, imaging, and outcome data between the two groups.

Main Results:

  • CGM patients were younger, had fewer underlying diseases, and less focal neurologic deficit compared to CNM patients.
  • CGM cases showed higher intracranial pressure, more meningeal enhancement, more lung cryptococcomas, faster cerebrospinal fluid fungal clearance, and fewer complications.
  • CGM patients experienced more favorable outcomes (94.1%) than CNM patients (64.1%).

Conclusions:

  • Species identification of Cryptococcus is essential for tailoring treatment strategies.
  • Distinct clinical and radiological features differentiate CGM from CNM.
  • Accurate species identification improves the prediction of patient outcomes in cryptococcal meningitis.
Keywords:
Cryptococcus gattiiHIV-negativeimagingmetagenomic next-generation sequencingoutcome

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