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Cryptococcosis, 90-day mortality higher in non-HIV nontransplant patients

21 Sep 2019

Cryptococcosis is more common in nonhuman immunodeficiency virus (HIV) nontransplant (NHNT) patients, and this population tends to have more localized pulmonary cryptococcosis and significantly higher 90-day mortality, reports a study.

This single-centre, retrospective study included patients diagnosed with cryptococcosis from 2002 through 2007 and analysed data on demographics, clinical features, diagnostics and mortality.

Of the 304 patients with Cryptococcus neoformans infections, 105 (35 percent) were people living with HIV, 41 (13 percent) had a history of transplantation, and 158 (52 percent) were NHNT. In age analysis, people living with HIV were younger (40 years) than transplant (53 years) and NHNT (61 years; p<0.001).

Fevers and headache occurred more frequently in people living with HIV (70 percent and 57 percent) than in transplant (49 percent and 29 percent) and NHNT (49 percent and 38 percent; p=0.003 and p=0.001), respectively.

Meningitis was more common in people living with HIV (68 percent) as compared with transplant (32 percent) or NHNT (39 percent; p<0.001). Disseminated cryptococcosis also occurred frequently in people living with HIV (97 percent) than in transplant (66 percent) or NHNT (73 percent; p<0.001).

Transplant recipients (median, 2 days; interquartile range [IQR], ±9 days) and NHNT patients (median, 2 days; IQR, ±7 days) had longer time to diagnosis from hospitalization than people living with HIV (median, 1 day; IQR ±2 days; p=0.003).

Moreover, the risk of 90-day mortality was higher in NHNT patients (hazard ratio, 3.3, 95 percent CI, 1.9–5.8) than in people living with HIV.

“Cryptococcosis in NHNT patients appears to be a distinct entity that needs further study and requires a higher level of clinical suspicion than it currently receives,” the authors said.

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Most Read Articles
6 days ago
Chest pain appears to be the principal complaint of patients hospitalized with a first myocardial infarction (MI), particularly among those in the youngest age group, a study has found.
Jairia Dela Cruz, 16 Sep 2020
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.
Pearl Toh, 6 days ago
Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.
Yesterday
Percutaneous coronary intervention (PCI), compared with coronary artery bypass grafting (CABG), in the revascularization of left main coronary artery (LMCA) disease may lead to death, myocardial infarction (MI), or stroke in patients with moderate or severe left ventricular (LV) dysfunction, reveals a study.