Central Nervous System Cryptococcosis among a Cohort of HIV Infected Patients from a University Hospital of North India

Nigam, Chaitanya

doi:10.7860/jcdr/2012/4158.2365

Cited by 6 publications

(8 citation statements)

References 10 publications

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“…A difference in the incidence of cryptococcal meningitis in men and women in different countries and in different regions in the same country has been observed. In the present study, the ratio of incidence among men and women was 10:1 proving male preponderance, which is comparable to the findings of various other studies [8,10,12,13]. A possible explanation for this could be higher exposure of the infection in men as opposed to varying susceptibilities towards the infection [10].…”

Section: Discussionsupporting

confidence: 90%

“…In the present study, considering culture as gold standard, the incidence of cryptococcal meningitis was observed to be 14.70% in the patient group. The findings are in accordance with published data from North India and were significantly higher as compared to south India population [8][9][10]. A possible explanation for persisting high incidence of cryptococcal meningitis could be poor adherence to Anti-retroviral therapy (ART).…”

Section: Discussionsupporting

confidence: 89%

“…This could be explained by the reason that empirical Amphotericin B was started on strong clinical suspicion of cryptococcal meningitis immediately on admission as the patients presented with altered sensorium and culture can be falsely negative when fungal burden is low. Similar findings were observed by the other studies [8][9][10]15,16].…”

Section: Methodssupporting

confidence: 92%

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Cryptococcal Meningitis in HIV Patients from a Tertiary Care Centre in Northern India

Sharma¹,

Achra²,

Kumari³

et al. 2019

NJLM

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 89%

See 1 more Smart Citation

Cryptococcal Meningitis in HIV Patients from a Tertiary Care Centre in Northern India

Sharma¹,

Achra²,

Kumari³

et al. 2019

NJLM

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“…Unlike data collected from North America [ 9 , 10 ], South America [ 7 , 8 ], Europe [ 11 ] and other countries in Asia [ 5 , 6 , 12 ], the incidence of cryptococcosis in immunocompetent patients is high in China. Chen et al [ 1 ] had summarized some features of cryptococcosis in China, but their focus was towards therapy.…”

Section: Introductionmentioning

confidence: 99%

A retrospective study of contributing factors for prognosis and survival length of cryptococcal meningoencephalitis in Southern part of China (1998–2013)

Zheng

Luo

et al. 2015

BMC Infect Dis

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BackgroundCryptococcal meningoencephalitis (CM) is the most common opportunistic infection of the central nervous system (CNS). Despite this observation, there have only been a few studies analyzing clinical characteristics as well as cerebrospinal fluid (CSF), electroencephalograph (EEG), and magnetic resonance imaging (MRI) features in CM patients of all ages.MethodsWe reviewed the medical records of all patients diagnosed with cryptococcal meningoencephalitis from 1998 to 2013 in the Nanfang Hospital in China and gathered data on the underlying diseases, bird exposure history, and clinical features, including those from CSF, EEG and MRI.ResultsCM is more likely to infect adults younger than 60 years old. 71.3% of CM patients were male. Unlike data from other countries, we found that chronic use of corticosteroids or other immunosuppressants (17.59%) was the most frequent risk factor in CM patients rather than HIV infection (1.85%). Clear exposure with bird/ bird droppings before CM onset is obvious in a previous study in CM children. However, our study found that 4.63% CM patients had such an exposure. More importantly, patients with brain tissue damage (p = 0.021) and decreased CSF/blood glucose ratio (p = 0.008) were significantly associated with death, but only the decreased CSF/blood glucose ratio was the contributing factor of prognosis (odds ratio, 0.047; p = 0.025). Decreased CSF/blood glucose ratio was significantly related to the survival length of CM (odds ratio, 0.134; p = 0.033).ConclusionsOur study shows that CM has predilection for young male adults. The chronic use of corticosteroids or other immunosuppressants, rather than HIV infection or bird/bird droppings exposure, was the most frequent risk factor in CM patients in our study. Decreased CSF/blood glucose ratio was both an independent contributing factor to death and was significantly related to the survival length of CM patients. The more decreased the CSF/blood glucose ratio was, the worse prognosis and shorter survival length CM patients had.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-0826-y) contains supplementary material, which is available to authorized users.

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“…A variety of opportunistic infections occur in immunocompromised patients, of which C. neoformans is the most common central nervous system infection. 4 , 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics, Cryptococcus neoformans genotypes, antifungal susceptibility, and outcomes in human immunodeficiency virus-positive patients in Beijing, China

Wang

et al. 2021

J Int Med Res

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Cryptococcus neoformans is an environmental fungal pathogen that causes opportunistic infections and severe disseminated meningoencephalitis, mainly in immunocompromised patients such as those with acquired immunodeficiency syndrome (AIDS). In this study, the clinical characteristics, treatment protocols, and outcomes of 70 patients with AIDS and Cryptococcus neoformans infection at Beijing Ditan Hospital were retrospectively analyzed. We performed antimicrobial sensitivity tests and multilocus sequence typing (MLST) on C. neoformans isolates from these patients. The most common symptoms were headache (58.6%), fever (54.3%), and high cerebrospinal fluid pressure (≥200 mm H2O) (71.4%). All patients were positive for C. neoformans antigen in blood or cerebrospinal fluid. The CD4 cell counts of 92.8% (65/70) of patients were <100 cells/µL. In total, 74 C. neoformans isolates were obtained from the 70 patients. The 65 isolates that could be typed fell into 12 sequence types (STs) by MLST: ST5, ST31, ST63, ST202, ST237, ST289, ST295, ST296, ST298, ST324, ST337, and ST359. ST5 was the major type, accounting for 78.5% of isolates (51/65). This study comprehensively assessed the clinical and molecular epidemiology of C. neoformans in patients with AIDS and may inform the development of targeted prevention and treatment strategies for immunocompromised patients with C. neoformans infection.

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Central Nervous System Cryptococcosis among a Cohort of HIV Infected Patients from a University Hospital of North India

Cited by 6 publications

References 10 publications

Cryptococcal Meningitis in HIV Patients from a Tertiary Care Centre in Northern India

Cryptococcal Meningitis in HIV Patients from a Tertiary Care Centre in Northern India

A retrospective study of contributing factors for prognosis and survival length of cryptococcal meningoencephalitis in Southern part of China (1998–2013)

Clinical characteristics, Cryptococcus neoformans genotypes, antifungal susceptibility, and outcomes in human immunodeficiency virus-positive patients in Beijing, China

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