Epidemiological characterization and prognostic factors in patients with confirmed cerebral cryptococcosis in central Taiwan

Journal of venomous animals and toxins

Hua-Cheg Yen¹  Yu-Jun Chang³  Shao-Hung Wang⁴  Yu-Min Chen⁵  Li-Jhen Lin⁶  Chang-Hua Chen⁷  Hiu-Ngar Sy⁸  Wei-Liang Chen⁸ 

[1] Nursing, Hung Kuang University, Taichung, Taiwan;Department of Medical Imaging, Changhua Christian Hospital, Changhua, Taiwan;Department of Microbiology, Immunology and Biopharmaceuticals, National Chiayi University, Chiayi City, Taiwan;Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan;Department of Neurosurgery, Changhua Christian Hospital, Changhua, Taiwan;Department of Nursing, College of Medicine &Division of Infectious Disease, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Changhua, Taiwan;Infection Control Committee, Changhua Christian Hospital, Changhua, Taiwan

关键词: Cryptococcus neoformans;    Cryptococcus gattii Cryptococcosis;    Meningitis;    Outcome;    Risk Assessment;   

DOI  :  10.1186/s40409-015-0012-0

学科分类：药理学

来源: BioMed Central

【 摘 要 】

Cryptococcal meningitis is a deadly fungal infection. This study aimed to characterize the epidemiology of cerebral cryptococcosis and to define its prognostic factors. This cross-sectional study collected clinical information from cryptococcal meningitis patients with confirmed cerebral cryptococcosis from 2006 to 2012 at the Changhua Christian Healthcare System to access prognostic factors. Fifty-nine adult cryptococcal meningitis patients were studied. The incidence at Changhua Christian Healthcare System was approximately 170 episodes per 100,000 patients within the studied period. Forty-one of 59 cryptococcal meningitis patients developed complications. Overall, 12 of 59 patients died, for a three-month mortality rate of 20.3 %. Prognostic factors positively associated with the three-month mortality included age (>55 years), patient delay, prolonged delay by the doctor in administering antifungal agent therapy, duration of intensive care unit stay, chronic lung disease, cryptococcemia, headache, altered mental status, positive blood cultures, and high cerebrospinal fluid opening pressure (≥250 mm H2O). We strongly recommend early administration of an antifungal agent to each suspected cryptococcal meningitis patient to decrease both the delay by doctors in administering therapy and the mortality risk. Aggressive and supportive care for severe cryptococcal meningitis patients is critical to decrease overall mortality from this infection.

【 授权许可】

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