Cryptococcosis in patients with hematological diseases: a 14-year retrospective clinical analysis in a Chinese tertiary hospital

BMC Infectious Diseases

Research Article

Xuan Wang¹  Li-ping Zhu¹  Hua-zhen Zhao¹  Yan-qiong Chen¹  Ji-qin Wu¹  Ya-hui Cao¹  Rui-ying Wang¹ 

[1] Department of Infectious Diseases, Huashan Hospital, Fudan University, 12 Central Urumqi Road, Shanghai, China;

关键词: Cryptococcosis;    Hematological diseases;    Cryptococcal meningitis;    Pulmonary cryptococcosis;    HIV-uninfected;   

DOI  :  10.1186/s12879-017-2561-z

 received in 2016-12-21, accepted in 2017-06-22,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundCryptococcal infection has become a public health challenge globally. However, information about cryptococcal infection in patients with hematological diseases remains relatively rare.MethodsHIV-uninfected cryptococcosis cases with hematological diseases admitted to Huashan Hospital from January 2001 to December 2014 were reviewed.ResultsIn total, 33 cryptococcosis patients were enrolled, including 12 malignant and 21 non-malignant hematological cases. Twenty-six patients had central nervous system (CNS) involvement, which was observed more often in patients with non-malignancies than with malignancies (20/21 vs. 6/12, P = 0.001) Most patients (25/26) with CNS infection were confirmed by cerebrospinal fluid (CSF) culture or smear, and 100% (20/20) of them tested positive for the CSF cryptococcal antigen test. Eighteen out of 26 cryptococcal meningitis patients were treated with amphotericin B (AmB)-based therapy, 16 of them with AmB deoxycholate (d-AmB) and 2 patients with liposomal AmB. The clinical success rate was 55.6%. D-AmB was well-tolerated at 0.35–0.59 mg/kg/d (median 0.43 mg/kg/d) and only 12 patients had mild adverse events.ConclusionsCNS cryptococcal infection was more frequent in patients with hematological non-malignancies, and cryptococcal antigen test as well as the CSF fungal culture or smear are suggested for early diagnosis. D-AmB could be used as an alternative therapy for CNS-infected patients with hematological diseases.

【 授权许可】

CC BY   
© The Author(s). 2017