Cryptococcosis in human immunodeficiency virus-negative patients in the era of effective azole therapy.
Published
Journal Article
We conducted a case study of human immunodeficiency virus (HIV)-negative patients with cryptococcosis at 15 United States medical centers from 1990 through 1996 to understand the demographics, therapeutic approach, and factors associated with poor prognosis in this population. Of 306 patients with cryptococcosis, there were 109 with pulmonary involvement, 157 with central nervous system (CNS) involvement, and 40 with involvement at other sites. Seventy-nine percent had a significant underlying condition. Patients with pulmonary disease were usually treated initially with fluconazole (63%); patients with CNS disease generally received amphotericin B (92%). Fluconazole was administered to approximately two-thirds of patients with CNS disease for consolidation therapy. Therapy was successful for 74% of patients. Significant predictors of mortality in multivariate analysis included age > or =60 years, hematologic malignancy, and organ failure. Overall mortality was 30%, and mortality attributable to cryptococcosis was 12%. Cryptococcosis continues to be an important infection in HIV-negative patients and is associated with substantial overall and cause-specific mortality.
Full Text
Duke Authors
Cited Authors
- 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
Published Date
- September 1, 2001
Published In
- Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Volume / Issue
- 33 / 5
Start / End Page
- 690 - 699
PubMed ID
- 11477526
Pubmed Central ID
- 11477526
International Standard Serial Number (ISSN)
- 1058-4838
Digital Object Identifier (DOI)
- 10.1086/322597
Language
- eng
Conference Location
- United States