Retrospective analysis of 149 cases of cryptococcal meningitis with AIDS

Abstract

Abstract:

Objective To describe the demographic characteristics, laboratory profile, therapeutic and outcome of cases diagnosed as cryptococcal meningitis with AIDS in Chongqing. Methods We analyzed the cryptococcosis cases diagnosed in the Chongqing Public Health Medical Center from January 2016 to January 2018.The diagnosis was confirmed by culture on Sabouraud's dextrose agar and/or by India ink preparation. The diagnosis methods were assessed by using culture as reference. Results A total of 149 cases of cryptococcal meningitis were diagnosed. The mean age of the patients was 42.54±12.94 years, and the male dominated(72.5%).The median CD4⁺ count was 24.00 cells/μL. India ink staining presented positive rate at 98.00%, the sensitivity at 96.80%,the specificity at 100.00%,and the diagnostic coincidence rate at 61.1%.The hospital mortality rate was 12.08% (18/149).Youth (18~44 years) and middle age (44~60 years), weight loss within 2 kg, normal or decreased chloride in cerebrospinal fluid before the initiation of anti-fungal treatment were the protective factors for the hospitalized patients,while the headache, disturbance of consciousness, fatigue, baseline CD4⁺ T cells for the number of 5~12 cells/μL, the initial the brain pressure greater than 250mm/H₂O as risk factors. Age of 18~44 years was the independent protective factor, disturbance of consciousness and fatigue were two independent risk factors for hospitalized patients. The difference was statistically significant. Conclusion The mortality of patients with AIDS combined with cryptococcal meningitis was high, the clinical manifestations were complex, and the prognosis was influenced by many factors, so it was necessary to attach great importance to the medical workers and strengthen the comprehensive management of the disease.

Key words: AIDS, cryptococcal meningitis, clinical features, prognostic factors

CLC Number:

R519.4

LU Yan-qiu, WU Yu-shan, QIU Dan, CHEN Yao-kai. Retrospective analysis of 149 cases of cryptococcal meningitis with AIDS[J]. Chinese Journal of Mycology, 2019, 14(4): 204-209.

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