Characteristics of HIV-associated cryptococcal meningitis in a tertiary Chilean hospital: An observational retrospective study

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dc.contributor.authorElicer, Isabel
dc.contributor.authorEugenin, Laura
dc.contributor.authorAcuna, Maria Paz
dc.contributor.authorUslar, Wilhelm
dc.contributor.authorFernandez, Ana
dc.contributor.authorLasso, Martin
dc.date.accessioned2025-01-20T16:13:29Z
dc.date.available2025-01-20T16:13:29Z
dc.date.issued2024
dc.description.abstractBackground: 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), inhospital 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.
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.clineuro.2024.108423
dc.identifier.eissn1872-6968
dc.identifier.issn0303-8467
dc.identifier.urihttps://doi.org/10.1016/j.clineuro.2024.108423
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/90389
dc.identifier.wosidWOS:001267385600001
dc.language.isoen
dc.revistaClinical neurology and neurosurgery
dc.rightsacceso restringido
dc.subjectCryptococcal meningitis
dc.subjectHIV
dc.subjectAIDS
dc.subjectopportunistic infections
dc.subjectelevated intracranial pressure
dc.subjectantifungal
dc.subjectLatin America
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleCharacteristics of HIV-associated cryptococcal meningitis in a tertiary Chilean hospital: An observational retrospective study
dc.typeartículo
dc.volumen244
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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