Advertisement

Mycopathologia

, Volume 173, Issue 5–6, pp 329–335 | Cite as

Cryptococcosis in China (1985–2010): Review of Cases from Chinese Database

  • Chen Yuchong
  • Che Fubin
  • Chen Jianghan
  • Wei Fenglian
  • Xu Nan
  • Yang Minghui
  • Sun Yalin
  • Zheng Zhizhong
Article

Abstract

Background

Cryptococcosis is a potential fatal disease, especially in immunocompromised patients. In China, the profile of cryptococcosis is unclear. Therefore, we summarize the epidemiology and therapy of cryptococcosis in china.

Methods

All cases reports about cryptococcosis in China were collected from CBMdisk database (China Biology and Medicine data disc) with key words of cryptococcosis, or cryptococcal infection, or cryptococcus, and case. The features of the cryptococcosis were retrospectively analyzed.

Results

There were 1,032 reports about cryptococcosis, including 8,769 cases. Among them, there were 16% patient with AIDS/HIV, and 17% ones without underlying diseases. There were 2,371 cases of CNS infection. Among them of 2,068 cases, the treatment protocols and outcome were clearly described. The percentages of patients who received intrathecal treatment of amphotericin B(AmB), AmB + 5-FC(5-fluorocytosine), AmB + FCZ(fluconazole), and AmB + 5-FU + FCZ in each medication group were 10, 43, 53, and 33%, respectively. The mortalities were significantly lower in the AmB, Amb + 5-FC, AmB + FCZ intrathecal treatment groups compared with their non-intrathecal treatment controls (6% vs. 23%, 25% vs. 35%, 20% vs. 30%, respectively, P < 0.05), but not in the intrathecal AmB + 5-FU + FCZ group (35% vs. 26%, P > 0.05).

Conclusion

The Chinese cryptococcosis had its own special clinical features, such as more patients without identifiable underlying diseases. Intrathecal injection of amphotericin B was effective treatment method for cryptococcal CNS infection in China.

Keywords

Cryptococcus Meningitis Acquired immune deficiency syndrome (AIDS) Amphotericin B 

Notes

Conflict of interest

None declared.

References

  1. 1.
    Perfect JR, Dismukes WE, Dromer F, et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of America. Clin Infect Dis. 2010;50:291–322.PubMedCrossRefGoogle Scholar
  2. 2.
    Subramanian S, Mathai D. Clinical manifestations and management of cryptococcal infection. J Postgrad Med. 2005;51:S21–6.PubMedGoogle Scholar
  3. 3.
    Tay ST, Rohani MY, Soo Hoo TS, et al. Epidemiology of cryptococcosis in Malaysia. Mycoses. 2009;53:509–14.CrossRefGoogle Scholar
  4. 4.
    Tintelnot K, Lemmer K, Losert H, et al. Follow-up of epidemiological data of cryptococcosis in Austria, Germany and Switzerland with special focus on the characterization of clinical isolates. Mycoses. 2004;47:455–64.PubMedCrossRefGoogle Scholar
  5. 5.
    Friedman GD, Jeffrey Fessel W, Udaltsova NV, et al. Cryptococcosis: the 1981–2000 epidemic. Mycoses. 2005;48:122–5.PubMedCrossRefGoogle Scholar
  6. 6.
    Chayakulkeeree M, Perfect JR. Cryptococcosis. In: Duane RH, Michael GR, editors. Diagnosis and treatment of human mycoses. Totowa, New Jersey: Humana Press; 2008. p. 255–77.CrossRefGoogle Scholar
  7. 7.
    Wu SX, Guo NR, Li XF, et al. Human pathogenic fungi in China–emerging trends from ongoing national survey for 1986, 1996, and 2006. Mycopathologia. 2011;171:387–93.PubMedCrossRefGoogle Scholar
  8. 8.
    Seboxa T, Alemu S, Assefa A, et al. Cryptococcal meningitis in patients with acquired immunodeficiency syndrome in prehaart era at Gondar College of Medical Sciences Hospital north-west Ethiopia. Ethiop Med J. 2010;48:237–41.PubMedGoogle Scholar
  9. 9.
    Bennett JE, Dismukes W, Duma RJ, et al. A comparison of amphotericin B alone and combined with flucytosine in the treatment of cryptococcal meningitis. N Engl J Med. 1979;301:126–31.PubMedCrossRefGoogle Scholar
  10. 10.
    Jongwutiwes U, Kiertiburanakul S, Sungkanuparph S. Impact of antiretroviral therapy on the relapse of cryptococcosis and survival of HIV-infected patients with cryptococcal infection. Curr HIV Res. 2007;5:355–60.PubMedCrossRefGoogle Scholar
  11. 11.
    Manosuthi W, Sungkanuparph S, Thongyen S, et al. Antifungal susceptibilities of Cryptococcus neoformans cerebrospinal fluid isolates and clinical outcomes of cryptococcal meningitis in HIV-infected patients with/without fluconazole prophylaxis. J Med Assoc Thai. 2006;89:795–802.PubMedGoogle Scholar
  12. 12.
    Tintelnot K, SchaÈr G, Polak A, et al. Epidemiological data of cryptococcosis in Austria, Germany and Switzerland: part of the ECMM survey in Europe. Mycoses. 2001;44:345–50.PubMedCrossRefGoogle Scholar
  13. 13.
    Chen J, Wen H, Wu J, et al. Adverse effects of amphotericin B during treatment of cryptococcal meningitis and their management. Acad J Sec Mil Med Univ. 2005;26:456–7.Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Chen Yuchong
    • 1
    • 2
  • Che Fubin
    • 2
  • Chen Jianghan
    • 2
  • Wei Fenglian
    • 2
  • Xu Nan
    • 2
  • Yang Minghui
    • 2
  • Sun Yalin
    • 3
  • Zheng Zhizhong
    • 1
  1. 1.Department of Dermatology, Huashan HospitalFudan UniversityShanghaiChina
  2. 2.Department of Dermatology and Mycology Center, Shanghai Changzheng HospitalSecond Military Medical UniversityShanghaiChina
  3. 3.Department of StatisticsSecond Military Medical UniversityShanghaiChina

Personalised recommendations