Characteristics and outcomes of cryptococcal meningitis in HIV seronegative children in Beijing, China, 2002–2013

BMC Infectious Diseases

Research Article

Lin-lin Liu¹  Shao-ying Li¹  Gang Liu¹  Tian-ming Chen¹  Ling-yun Guo²  Yue Liu³  Yong-hong Yang⁴ 

[1] Department of Infectious Diseases, Beijing Children’s Hospital, Capital Medical University, Beijing, China;Department of Infectious Diseases, Beijing Children’s Hospital, Capital Medical University, Beijing, China;Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics (Capital Medical University), Ministry of Education, National Clinical Research Centre for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, Beijing, China;Department of Radiology, Beijing Children’s Hospital, Capital Medical University, Beijing, China;Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics (Capital Medical University), Ministry of Education, National Clinical Research Centre for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, Beijing, China;

关键词: Juvenile Rheumatoid Arthritis;    Cryptococcosis;    Cryptococcal Meningitis;    Altered Mental Status;    Cryptococcal Antigen;   

DOI  :  10.1186/s12879-016-1964-6

 received in 2016-07-05, accepted in 2016-10-25,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundData regarding HIV-seronegative pediatric patients with cryptococcal meningitis (CM) have been very limited.MethodsWe retrospectively reviewed non-HIV-infected in patients with CM from January 2002 through December 2013 in Beijing Children’s Hospital. Records of the all patients were obtained and compared.ResultsThe 34 children had a median age of 5.6 years. Most of the patients were male (67.6 %). Only 23.5 % of the cases had identifiable underlying diseases. The sensitivity of the CSF cryptococcal antigen, India ink smear and CSF culture in our study were 81.5, 85.3 and 82.4 %, respectively. And the sensitivity of combinations of these tests was 91.2 %. Out of the 34 patients, 16 (47.1 %) had other organs involvement in addition to the brain. The main abnormal features via magnetic resonance imaging (MRI) were Virchow-Robin space dilatation (44.4 %), hydrocephalus (38.9 %), gelatinous pseudocysts (33.3 %), brain atrophy (33.3 %), meningeal enhancement (27.8 %) and local lesions (27.8 %). In total, 64.7 % of the patients were successfully treated at discharge, whereas treatment failed in 35.3 % of the patients.ConclusionsCryptococcal meningitis is an infrequent disease with a high fatality rate in children in China. The majority of patients were apparently healthy. Clinicians should consider cryptococcal infection as a potential pathogen of pediatric meningitis. Cryptococcal antigen, India ink smear and culture tests are recommended for diagnosis.

【 授权许可】

CC BY   
© The Author(s). 2016