Journal Article (Journal Article)

Previous reports have emphasized that cryptococcemia is almost uniformly fatal. To define the clinical course and prognostic and therapeutic implications of cryptococcemia, we studied 15 patients treated at this medical center over the past 7 years. Cryptococcemia was strongly associated with corticosteroid therapy, especially when the dosage had recently been increased. Meningitis was common (but not invariably present) in these patients, characteristically with a large burden of organisms in the cerebrospinal fluid. Cryptococcemia developed during hospitalization in one-third of our patients; this high rate of nosocomial infection emphasizes that C. neoformans infection should be considered in febrile, immunocompromised patients even when the initial work-up is negative. Most of these patients were treated with amphotericin B plus 5-fluorocytosine. Although the one-year survival rate of 4/15 (29%) was dismal, no patient died from uncontrolled cryptococcal infection. Other infections, which developed before, during or after cryptococcemia was diagnosed, were the major immediate cause of morbidity and mortality. The progress of underlying diseases and the outcome of concomitant infections in these patients were more important determinants of survival than was cryptococcemia itself.

Full Text

Duke Authors

Cited Authors

  • Perfect, JR; Durack, DT; Gallis, HA

Published Date

  • March 1983

Published In

Volume / Issue

  • 62 / 2

Start / End Page

  • 98 - 109

PubMed ID

  • 6338344

International Standard Serial Number (ISSN)

  • 0025-7974

Digital Object Identifier (DOI)

  • 10.1097/00005792-198303000-00003


  • eng

Conference Location

  • United States