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Pulmonary Tuberculosis I

Pulmonary Tuberculosis I

Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
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Cryptococcal Meningitis: Differences between Patients with and without HIV-Infection.

Chutithep Teekaput¹, Saowaluck Yasri², Romanee Chaiwarith²

¹Division of Neurology, Department of Internal Medicine, Faculty of Medicine Chiang Mai University, Chiang Mai 50200, Thailand.

Pathogens (Basel, Switzerland)

|March 29, 2023

Summary

Cryptococcal meningitis presents differently in HIV-infected versus HIV-uninfected individuals. Early diagnosis and treatment are crucial, especially for non-HIV patients, to reduce high mortality rates.

Keywords:

HIV-infection cryptococcal meningitis invasive fungal infection meningitis

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Area of Science:

Infectious Diseases
Mycology
Epidemiology

Background:

Cryptococcal meningitis is a severe infection, historically prevalent in individuals with Human Immunodeficiency Virus (HIV).
Increased immunosuppressant use has led to a rise in cryptococcosis among HIV-uninfected populations.
Understanding distinct characteristics between these groups is critical for effective management.

Purpose of the Study:

To compare the clinical characteristics and outcomes of cryptococcal meningitis between HIV-infected and HIV-uninfected patients.
To identify factors associated with HIV infection and mortality in cryptococcal meningitis cases.

Main Methods:

A retrospective cohort study was conducted in northern Thailand from 2011 to 2021.
147 patients aged ≥15 years diagnosed with cryptococcal meningitis were included.
Data analysis focused on comparing characteristics and identifying risk factors for infection and mortality.

Main Results:

Of 147 patients, 101 were HIV-infected and 46 were HIV-uninfected.
Factors associated with HIV infection included younger age (<45 years), low white blood cell count (<5000 cells/cu.mm.), and fungemia.
Overall mortality was 24%, with higher rates in HIV-uninfected (37%) versus HIV-infected (18%) individuals (p=0.020). Mortality predictors included concurrent pneumocystis pneumonia, altered consciousness, *C. gattii* infection, and anemia.

Conclusions:

Clinical presentations of cryptococcal meningitis vary between HIV-infected and HIV-uninfected patients.
Higher mortality in HIV-uninfected individuals underscores the need for increased physician awareness.
Prompt diagnosis and timely treatment in HIV-uninfected individuals are essential to improve outcomes.