Your browser doesn't support javascript.
loading
Characteristics of HIV-associated cryptococcal meningitis in a tertiary Chilean hospital: An observational retrospective study.
Elicer, Isabel; Eugenin, Laura; Acuña, María Paz; Uslar, Wilhelm; Fernández, Ana; Lasso, Martin.
Afiliación
  • Elicer I; Hospital Dr. Sótero del Río, Clínica Las Condes, Red Salud UC Christus City, Santiago, Chile. Electronic address: Isabel.elicer@gmail.com.
  • Eugenin L; Hospital Dr. Sótero del Río, Santiago, Chile. Electronic address: ldeugeni@uc.cl.
  • Acuña MP; Hospital Dr. Sótero del Río, Santiago, Chile. Hospital Eloísa Díaz La Florida, Santiago, Chile. Electronic address: paci.acuna@gmail.com.
  • Uslar W; Hospital Herminda Martín, Chillán, Chile. Red Salud UC Christus, Santiago, Chile. Electronic address: wfuslar@gmail.com.
  • Fernández A; Hospital Dr. Sótero del Río, Santiago, Chile. Electronic address: amfernandez@ssmso.cl.
  • Lasso M; Universidad Católica, Chief of Adult's Infectious Disease Unit, Hospital Dr. Sótero del Río, Chile. Electronic address: mlasso45@gmail.com.
Clin Neurol Neurosurg ; 244: 108423, 2024 Sep.
Article en En | MEDLINE | ID: mdl-38996802
ABSTRACT

BACKGROUND:

Central nervous system opportunistic infections can be the first presentation of an HIV infection. Our aim is to describe clinical and laboratory characteristics of HIV-associated Cryptococcal Meningitis (CM), in-hospital outcomes and analyze associations of these parameters with adverse outcomes.

METHODS:

Observational study of local cohort of HIV-associated cryptococcal meningitis in a high complexity tertiary urban hospital in Santiago, Chile. Descriptive analysis through chart review of all episodes of HIV-associated CM in adults, from 1995 to 2019. Inclusion criteria were confirmed CM with cerebrospinal fluid culture or India ink in the appropriate clinical context and HIV diagnosis. We selected relevant variables that have been described as predictors of adverse outcomes in the literature and explore associations in our cohort.

RESULTS:

There were 37 HIV associated CM cases, occurring from 2000 to 2019. Majority were men (86 %) with a median age of 35 years. CM was the first HIV manifestation in 32 %. Opening pressure was measured in 10 % of patients at admission. Most CSF parameters were mildly altered, and two patients presented with completely normal CSF findings. Most patients -94,4 %- suffered adverse events secondary to antifungal therapy. Despite of recommendations against their use, steroids were frequently prescribed. Mortality was 18,9 %, and was associated with older age, and more days of headache prior to admission.

CONCLUSIONS:

CM clinical presentation and CSF characteristics are variable at presentation, which can lead to delayed diagnosis. Inappropriate use of corticosteroids, antifungal toxicity and suboptimal management of elevated intracranial pressure are key aspects to improve.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Meningitis Criptocócica / Centros de Atención Terciaria Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: America do sul / Chile Idioma: En Revista: Clin Neurol Neurosurg Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Meningitis Criptocócica / Centros de Atención Terciaria Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: America do sul / Chile Idioma: En Revista: Clin Neurol Neurosurg Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos