Skip to main content
Journal cover image

Pulmonary cryptococcosis in patients without HIV infection: factors associated with disseminated disease.

Publication ,  Journal Article
Baddley, JW; Perfect, JR; Oster, RA; Larsen, RA; Pankey, GA; Henderson, H; Haas, DW; Kauffman, CA; Patel, R; Zaas, AK; Pappas, PG
Published in: Eur J Clin Microbiol Infect Dis
October 2008

Cryptococcus neoformans is an uncommonly recognized cause of pneumonia in HIV-negative patients. Because of its propensity to disseminate to the meninges and other sites, a lumbar puncture is recommended for patients with pulmonary cryptococcosis, regardless of other risk factors. This study explored clinical and laboratory features to help predict which patients had pulmonary disease alone versus those who had pulmonary plus extrapulmonary disease. A retrospective chart review at 15 medical centers was performed from 1990 to 2000 of all HIV-negative patients who had pulmonary cryptococcosis. Demographic, clinical, radiographic, and laboratory features were evaluated to determine factors that differentiated those patients who had extrapulmonary disease. Among 166 patients who had pulmonary cryptococcosis, 122 had pulmonary infection only and 44 had pulmonary plus extrapulmonary (disseminated) disease. A negative serum cryptococcal antigen titer was more common in patients with pulmonary disease alone (p < 0.01). Multivariate analysis demonstrated that patients who had disseminated disease were more likely than those who only had pulmonary disease to have cirrhosis (p = 0.049), headache (p < 0.001), weight loss (p = 0.003), fever (p = 0.035), altered mental status (p < 0.001), and to be receiving high-dose corticosteroids (p = 0.008). In this large cohort of HIV-negative patients with pulmonary cryptococcosis, there were easily distinguished clinical and laboratory features among patients with pulmonary disease alone versus those with pulmonary plus extrapulmonary disease. These findings may be helpful in the evaluation of HIV-negative patients with pulmonary cryptococcosis with regard to the need for lumbar puncture or to search for disseminated disease.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Eur J Clin Microbiol Infect Dis

DOI

EISSN

1435-4373

Publication Date

October 2008

Volume

27

Issue

10

Start / End Page

937 / 943

Location

Germany

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Pneumonia
  • Middle Aged
  • Microbiology
  • Meningitis, Cryptococcal
  • Male
  • Humans
  • Female
  • Cryptococcus neoformans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Baddley, J. W., Perfect, J. R., Oster, R. A., Larsen, R. A., Pankey, G. A., Henderson, H., … Pappas, P. G. (2008). Pulmonary cryptococcosis in patients without HIV infection: factors associated with disseminated disease. Eur J Clin Microbiol Infect Dis, 27(10), 937–943. https://doi.org/10.1007/s10096-008-0529-z
Baddley, J. W., J. R. Perfect, R. A. Oster, R. A. Larsen, G. A. Pankey, H. Henderson, D. W. Haas, et al. “Pulmonary cryptococcosis in patients without HIV infection: factors associated with disseminated disease.Eur J Clin Microbiol Infect Dis 27, no. 10 (October 2008): 937–43. https://doi.org/10.1007/s10096-008-0529-z.
Baddley JW, Perfect JR, Oster RA, Larsen RA, Pankey GA, Henderson H, et al. Pulmonary cryptococcosis in patients without HIV infection: factors associated with disseminated disease. Eur J Clin Microbiol Infect Dis. 2008 Oct;27(10):937–43.
Baddley, J. W., et al. “Pulmonary cryptococcosis in patients without HIV infection: factors associated with disseminated disease.Eur J Clin Microbiol Infect Dis, vol. 27, no. 10, Oct. 2008, pp. 937–43. Pubmed, doi:10.1007/s10096-008-0529-z.
Baddley JW, Perfect JR, Oster RA, Larsen RA, Pankey GA, Henderson H, Haas DW, Kauffman CA, Patel R, Zaas AK, Pappas PG. Pulmonary cryptococcosis in patients without HIV infection: factors associated with disseminated disease. Eur J Clin Microbiol Infect Dis. 2008 Oct;27(10):937–943.
Journal cover image

Published In

Eur J Clin Microbiol Infect Dis

DOI

EISSN

1435-4373

Publication Date

October 2008

Volume

27

Issue

10

Start / End Page

937 / 943

Location

Germany

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Pneumonia
  • Middle Aged
  • Microbiology
  • Meningitis, Cryptococcal
  • Male
  • Humans
  • Female
  • Cryptococcus neoformans