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Prediction of unfavorable outcomes in cryptococcal meningitis: results of the multicenter Infectious Diseases International Research Initiative (ID-IRI) cryptococcal meningitis study

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dc.contributor.authorTİGEN, ELİF
dc.contributor.authorsHakyemez, I. N.; Erdem, H.; Beraud, G.; Lurdes, M.; Silva-Pinto, A.; Alexandru, C.; Bishop, B.; Mangani, F.; Argemi, X.; Poinot, M.; Hasbun, R.; Sunbul, M.; Akcaer, M.; Alp, S.; Demirdal, T.; Angamuthu, K.; Amer, F.; Ragab, E.; Shehata, G. A.; Ozturk-Engin, D.; Ozgunes, N.; Larsen, L.; Zimmerli, S.; Sipahi, O. R.; Tigen, E. Tukenmez; Celebi, G.; Oztoprak, N.; Yardimci, A. C.; Cag, Y.
dc.date.accessioned2022-03-12T22:27:55Z
dc.date.available2022-03-12T22:27:55Z
dc.date.issued2018
dc.description.abstractCryptococcal meningitis (CM) is mostly seen in immunocompromised patients, particularly human immunodeficiency virus (HIV)-positive patients, but CM may also occur in apparently immunocompetent individuals. Outcome analyses have been performed in such patients but, due to the high prevalence of HIV infection worldwide, CM patients today may be admitted to hospitals with unknown HIV status, particularly in underdeveloped countries. The objective of this multicenter study was to analyze all types of CM cases in an aggregate cohort to disclose unfavorable outcomes. We retrospectively reviewed the hospitalized CM patients from 2000 to 2015 in 26 medical centers from 11 countries. Demographics, clinical, microbiological, radiological, therapeutic data, and outcomes were included. Death, neurological sequelae, or relapse were unfavorable outcomes. Seventy (43.8%) out of 160 study cases were identified as unfavorable and 104 (65%) were HIV infected. On multivariate analysis, the higher Glasgow Coma Scale (GCS) scores (p = 0.021), cerebrospinal fluid (CSF) leukocyte counts > 20 (p = 0.038), and higher CSF glucose levels (p = 0.048) were associated with favorable outcomes. On the other hand, malignancy (p = 0.026) was associated with poor outcomes. Although all CM patients require prompt and rational fungal management, those with significant risks for poor outcomes need to be closely monitored.
dc.identifier.doi10.1007/s10096-017-3142-1
dc.identifier.eissn1435-4373
dc.identifier.issn0934-9723
dc.identifier.pubmed29218468
dc.identifier.urihttps://hdl.handle.net/11424/235260
dc.identifier.wosWOS:000435950400004
dc.language.isoeng
dc.publisherSPRINGER
dc.relation.ispartofEUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectHUMAN-IMMUNODEFICIENCY-VIRUS
dc.subjectHIV-NEGATIVE PATIENTS
dc.subjectRISK-FACTORS
dc.subjectPROGNOSTIC-FACTORS
dc.subjectNEOFORMANS INFECTION
dc.subjectMORTALITY
dc.subjectEPIDEMIOLOGY
dc.subjectDETERMINANTS
dc.subjectINDICATORS
dc.subjectFEATURES
dc.titlePrediction of unfavorable outcomes in cryptococcal meningitis: results of the multicenter Infectious Diseases International Research Initiative (ID-IRI) cryptococcal meningitis study
dc.typearticle
dspace.entity.typePublication
local.avesis.idc7c08ee9-36de-4288-92f5-2acf89c79591
local.import.packageSS17
local.indexed.atWOS
local.indexed.atSCOPUS
local.indexed.atPUBMED
local.journal.numberofpages10
local.journal.quartileQ3
oaire.citation.endPage1240
oaire.citation.issue7
oaire.citation.startPage1231
oaire.citation.titleEUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
oaire.citation.volume37
relation.isAuthorOfPublicationfad8e847-d87e-49b7-ad74-3ff14b50ed24
relation.isAuthorOfPublication.latestForDiscoveryfad8e847-d87e-49b7-ad74-3ff14b50ed24

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