Abstract
Cryptococcus neoformans usually causes disease in patients with human immunodeficiency virus (HIV) infection. This descriptive study was based on a retrospective review of 33 HIV-uninfected patients with disseminated cryptococcosis from 1998 to 2005. An underlying condition associated with immunocompromise was documented in 30 patients (90.9%), including liver cirrhosis (36.4%), diabetes mellitus (33.3%) and autoimmune disease (27.3%). Disseminated cryptococcosis carried a high mortality rate in this series, reaching 63% overall, with a median survival of 21 days. All patients (12/12) with liver cirrhosis died within the first month after the diagnosis of cryptococcosis. Otherwise, high Acute Physiology and Chronic Health Evaluation II (APACHE II) score, female gender and smoking history were associated with worse one-month outcome.
Similar content being viewed by others
References
Pappas PG, Perfect JR, Cloud GA, Larsen RA, Pankey GA, Lancaster DJ, Henderson H, Kauffman CA, Haas DW, Saccente M, Hamill RJ, Holloway MS, Warren RM, Dismukes WE (2001) Cryptococcosis in human immunodeficiency virus-negative patients in the era of effective azole therapy. Clin Infect Dis 33:690–699
Rabkin JM, Oroloff SL, Corless CL, Benner KG, Flora KD, Rosen HR, Olyaei AJ (2000) Association of fungal infection and increased mortality in liver transplant recipients. Am J Surg 179:426–430
Vilchez RA, Irish W, Lacomis J, Costello P, Fung J, Kusne S (2001) The clinical epidemiology of pulmonary cryptococcosis in non-AIDS patients at a tertiary care medical center. Medicine (Baltimore) 80:308–312
Jean SS, Fang CT, Shau WY, Chen YC, Chang SC, Hsueh PR, Hung CC, Luh KT (2002) Cryptococcaemia: clinical features and prognostic factors. QJM 95:511–518
Chayakulkeeree M, Perfect JR (2006) Cryptococcosis. Infect Dis Clin North Am 3:507–544
Kokturk N, Ekim N, Kervan F, Arman D, Memis L, Caglar K, Kalkanci A, Demircan S, Kurul C, Akyurek N (2005) Disseminated cryptococcosis in a human immunodeficiency virus-negative patient: a case report. Mycoses 48:270–274
Pasqualotto AC, Bittencourt Severo C, de Mattos Oliveira F, Severo LC (2004) Cryptococcemia. An analysis of 28 cases with emphasis on the clinical outcome and its etiologic agent. Rev Iberoam Micol 21:143–146
Wang CY, Wu HD, Hsueh PR (2005) Nosocomial transmission of cryptococcosis. N Engl J Med 352:1271–1272
Franca AV, Carneiro M, dal Sasso K, Souza Cda S, Martinelli A (2005) Cryptococcosis in cirrhotic patients. Mycoses 48:68–72
Mabee CL, Mabee SW, Kirkpatrick RB, Koletar SL (1995) Cirrhosis: a risk factor for cryptococcal peritonitis. Am J Gastroenterol 90:2042–2045
Hsu CC, Leevy CM (1971) Inhibition of PHA-stimulated lymphocyte transformation by plasma from patients with advanced alcoholic cirrhosis. Clin Exp Immunol 8:749–760
Nouri-Aria KT, Alexander GJ, Portmann BC, Hegarty JE, Eddleston AL, Williams R (1986) T and B cell function in alcoholic liver disease. J Hepatol 2:195–207
Perfect JR, Durack DT, Gallis HA (1983) Cryptococcemia. Medicine (Baltimore) 62:98–109
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Chuang, YM., Ho, YC., Chang, HT. et al. Disseminated cryptococcosis in HIV-uninfected patients. Eur J Clin Microbiol Infect Dis 27, 307–310 (2008). https://doi.org/10.1007/s10096-007-0430-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10096-007-0430-1