Cryptococcal Meningitis in HIV-Negative Patients: A 12-Year Single-Center Experience in China

Author:

Huang Yu12,Jin Xiaozhi12,Wu Faling12,Pan Tongtong1,Wang Xiaodong1ORCID,Chen Dazhi13,Chen Yongping12ORCID

Affiliation:

1. Zhejiang Provincial Key Laboratory for Accurate Diagnosis and Treatment of Chronic Liver Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, China

2. Department of Infectious Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, China

3. Department of Clinical Medicine, Hangzhou Medical College, Hangzhou 310053, China

Abstract

Objective: Cryptococcal meningitis (CM) is a not rare condition in HIV-negative patients. Here, we describe the clinical characteristics, possible risk factors, and outcomes of HIV-negative patients with CM. Methods: Medical records from 99 HIV-negative patients with CM admitted to our hospital from 2010 to 2021 were reviewed systematically. We compared the clinical features and outcomes between patients with underlying diseases and otherwise healthy hosts. Results: The 99 HIV-negative CM patients had a mean age at presentation of 56.2 ± 16.2 years, and the female-to-male ratio was 77:22. A total of 52 (52.5%) CM patients had underlying conditions, and 47 patients (47.5%) had no underlying conditions. Kidney transplant represented the most frequent underlying condition (11.1%), followed by rheumatic disease (10.1%) and hematological diseases (9.1%). Compared to patients without underlying conditions, those with underlying conditions had significantly more fever, more steroid therapy, higher serum creatinine, and lower albumin, IgG, hemoglobin, and platelets (p < 0.05 for each). CM patients without underlying conditions had significantly more alcohol abuse than those with underlying conditions (31.9% vs. 9.6%, p = 0.011). By logistic regression analysis, male gender (OR = 3.16, p = 0.001), higher CSF WBC (OR = 2.88, p = 0.005), and protein (OR = 2.82, p = 0.002) were significantly associated with mortality. Conclusion: Patients with underlying conditions had a similar mortality to patients without underlying conditions. Alcohol abuse was a probable risk factor for CM for previously healthy patients. Male gender, higher CSF WBC, and protein were significantly associated with mortality.

Funder

National Natural Science Foundation of China

Natural Science Foundation of Zhejiang Province

Public Welfare Science and Technology Project of Wenzhou

Major science and technology plan of Zhejiang Province

Publisher

MDPI AG

Subject

General Medicine

Cited by 3 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Identification of risk factors for disseminated cryptococcosis in non-hiv patients: a retrospective analysis;European Journal of Medical Research;2023-12-19

2. Cryptococcal Meningitis in Young, Immunocompetent Patients: A Single-Center Retrospective Case Series and Review of the Literature;Open Forum Infectious Diseases;2023-08-01

3. Cryptococcosis of the Central Nervous System;Viral and Fungal Infections of the Central Nervous System: A Microbiological Perspective;2023

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