Clinical features of 55 patients with non-human immunodeficiency virus-associated cryptococcal meningitis

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Author: LIN Huizhen ¹ ZHANG Die ² LIU Zengjing ³ Huang Xiaoqun ⁴ LI Chunting ⁵ FANG Sheng ⁶ LI Ling ⁷ HUANG Meiyan ⁸ HUANG Cheng ⁹  HU Yanling ¹⁰

Affiliation: 1. Department of Microbiology, School of Basic Medical Sciences, Guangxi Medical University / Department of Clinical Laboratory, Wuming Hospital of Guangxi Medical University, Nanning 530199, China 2. Guangxi Collaborative Innovation Centre for Biomedicine, Guangxi Medical University, Nanning 530022, China 3. Department of Medical Quality Management, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545000, Guangxi Zhuang Autonomous Region, China 4. Department of Clinical Laboratory, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530011, China 5. Department of Clinical Laboratory, Pingnan People's Hospital, Guigang 537300, Guangxi Zhuang Autonomous Region, China 6. Department of Critical Care Medicine, Ningming People's Hospital, Chongzuo 532500, Guangxi Zhuang Autonomous Region, China 7. Department of Clinical Laboratory, Jingxi People's Hospital, Jingxi 533800, Guangxi Zhuang Autonomous Region, China 8. Department of Clinical Laboratory, The People's Hospital of Shanglin, Nanning 530500, China 9. Department of Clinical Laboratory, The People's Hospital of DuAn Yao Autonomous County, Hechi 530700, Guangxi Zhuang Autonomous Region, China 10. Life Sciences Institute, Guangxi Medical University, Nanning 530022, China

Keywords: Cryptococcal meningitis Non-human immunodeficiency virus Clinical features Laboratory examination Early diagnosis and treatment

DOI: 10.12173/j.issn.1004-4337.202402006

Reference: Lin HZ, Zhang D, Liu ZJ, Huang XQ, Li CT, Fang S, Li L, Huang MY, Huang C, Hu YL. Clinical features of 55 patients with non-human immunodeficiency virusassociated cryptococcal meningitis[J]. Journal of Mathematical Medicine, 2024, 37(6): 462-469. DOI: 10.12173/j.issn.1004-4337.202402006[Article in Chinese]  Copied

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Abstract

Objective The clinical characteristics of 55 patients with non-human immunodeficiency virus (HIV)-associated cryptococcal meningitis (CM) were analyzed to provide scientific basis for early clinical diagnosis of the disease.

Methods The electronic medical records of 55 patients with non-HIV-associated CM diagnosed in Wuming Hospital of Guangxi Medical University and 5 other primary hospitals from January 2004 to October 2023 were retrospectively studied, and their past medical history, first clinical features, laboratory examination and imaging examination were analyzed.

Results Among 55 patients with non-HIV-associated CM, 27 were males (49.1%), and the median age was 57 years (43, 67). 40 patients (72.73%) lived in rural areas, 32 patients (58.18%) had underlying diseases. Headache was the most typical initial clinical symptom (76.36%), followed by nausea and vomiting (50.91%), dizziness (45.45%), meningeal irritation (43.64%), and fever (41.82%). The percentage of intracranial pressure increase, cerebrospinal fluid (CSF) white blood cell count increase, CSF protein quantitative detection increase, CSF glucose quantitative detection decrease, and CSF chloride quantitative detection decrease were 73.33%, 94.34%, 86.00%, 68.52% and 64.81%, respectively. The percentage of white blood cells increase and neutrophils increase were 50.91% and 67.27%. Imaging abnormalities accounted for 50.91% , mainly included infarction, abnormal signal lesions and demyelinating lesions.

Conclusion Non-HIV-associated CM patients were mainly middle-aged and elderly patients, and the living environment was mainly rural. The first clinical features were headache, followed by nausea and vomiting, dizziness, positive meningeal irritation signs and fever. Most of the intracranial pressure and CSF related indicators were abnormal. Improving doctors' awareness of non-HIV-associated CM would benefit the early diagnosis and treatment of patients groups.

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