Epidemiology of Cryptococcal Meningitis in the US: 1997–2009

Abstract

Cryptococcal meningitis (CM) causes significant morbidity and mortality globally; however, recent national trends have not been described. Incidence and trends for CM-associated hospitalizations in 18 states were estimated using the Agency for Healthcare and Research Quality (AHRQ) State Inpatient Databases (SID) datasets for 1997 through 2009. We identified 30,840 hospitalizations coded for CM, of which 21.6% were among HIV-uninfected patients. CM in-hospital mortality was significant (12.4% for women and 10.8% for men) with a total of 3,440 deaths over the study period. Co-morbidities of CM coded at increased frequency in HIV-uninfected CM hospitalized populations included hydrocephalus and acute/chronic renal failure as well as possible predispositions including transplantation, combined T and B cell defects, Cushing’s syndrome, liver disease and hypogammaglobulinemia. Median hospitalization costs were significant for CM and higher for HIV-uninfected patients (16,803.01 vs. 15,708.07; p<0.0001). Cryptococcal meningitis remains a disease with significant morbidity and mortality in the U.S. and the relative burden among persons without HIV infection is increasing.

Role of microglia in fungal infections of the central nervous system

“…However, in severe cases, systemic mycosis can arise and disseminate hematogenously into the CNS. 5,6 Direct contiguous spread from the orbits, petromastoid region, and the paranasal sinuses can also occur in some patients. 3 Additionally, fungal infection with or without dissemination may occur during trauma, prosthetic valve placement, and intensive care or intracranial procedures.…”

Paciente inmunocompetente con criptococosis cerebral: reporte de un caso

“…Nuestra paciente no presentó datos de infección pulmonar previa; se han documentado casos de criptococosis pulmonar asintomáticos y de meningoencefalitis secundaria a infección pulmonar sin datos clínicos ni radiológicos pulmonares, y en estos casos la infección pulmonar es controlada por granulomas que desaparecen después de semanas o meses 16,17 . La presentación de la criptococosis en el SNC puede ser como quistes en la corteza cerebral con reacción meníngea granulomatosa, o granulomas en la sustancia blanca llamados criptococomas 18,19 , los cuales no se detectaron en nuestra paciente; su condición médica impidió realizar una resonancia magnética. Las manifestaciones clínicas de la criptococosis aparecen entre 1 y 2 semanas tras la exposición a esporas en heces de aves, plantas (eucaliptos) y animales (p.…”

A Cross-Sectional Study of Cryptococcal Antigenemia in Anti-Retroviral Naive Hiv Infected Patients

“…With the emergence of HIV/ AIDS pandemic, there was an increase in the number of individuals infected with Cryptococcus. 8 Other risk groups for cryptococcosis are transplant recipients on immunosuppressants and those with haematopoietic or other malignancies, advanced renal or liver disease, solid organ malignancy, sarcoidosis, rheumatologic disease and diabetes mellitus. [9][10][11] Detection of cryptococcal antigen in serum can be used as a presumptive diagnosis of cryptococcal meningitis.…”