Cryptococcosis natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Complications
- Meningitis
- Permanent brain or nerve damage
- Side effects of medications (such as Amphotericin B) can be severe
Prognosis
Prior to the introduction of amphotericin B therapy, cryptococcal meningitis was almost always fatal. Now, although most of these patients can be cured with course of intravenous amphotericin B, the optimum duration of therapy is often unclear, and there is still a significant percentage of early deaths and late treatment failure.[1][2][3]
The mortality of cryptococcal meningitis is high (10-30%).[4]
Increasing levels of the following worsens the prognosis of HIV-negative cryptococcal meningitis patients with acute/subacute onset;
- Ratio of CSF glucose/blood glucose
- Impaired consciousness and
- Hospitalization length
References
- ↑ Diamond RD, Bennett JE (1974). "Prognostic factors in cryptococcal meningitis. A study in 111 cases". Ann Intern Med. 80 (2): 176–81. PMID 4811791.
- ↑ Lewis JL, Rabinovich S (1972). "The wide spectrum of cryptococcal infections". Am J Med. 53 (3): 315–22. PMID 5054723.
- ↑ NEWCOMER VD, STERNBERG TH, WRIGHT ET, REISNER RM, McNALL EG, SORENSEN LJ (1960). "The treatment of systemic fungus infections with amphotericin B." Ann N Y Acad Sci. 89: 221–39. PMID 13728643.
- ↑ Van der Horst CM, Saag MS, Cloud GA et al. (1997) Treatment of cryptococcal meningitis associated with the acquired immunodeficiency syndrome. N Engl J Med, 337, 15–21.