Cryptococcosis in Denmark: an analysis of 28 cases in 1988-1993.
A total number of 31 events of systemic cryptococcal infection in 28 patients was identified in a nation-wide survey over 6 years from 1988 to the end of 1993. All medical records were reviewed, 24 of the patients were HIV-infected. Meningitis was diagnosed in 25 patients, and fungemia in 8 patients. The most frequent symptom was headache followed by fever. The median duration in days of fever, headache, and other neurological signs/symptoms before diagnosis was 12, 8 and 2 days, respectively, and, after diagnosis and start of treatments 7, 11 and 12 days, respectively. There was a significant correlation between the duration of headache and the duration of neurological signs/symptoms but not between headache and fever. More than 50% of the patients died within 5 months after the diagnosis. In 39% of the cases, the patients were orally treated with various antifungal drugs before the diagnosis. The rate of cryptococcosis (cumulative) in Danish AIDS patients was estimated to be 1.7%. The HIV-positive patients were, at the time of the cryptococcal diseases, profoundly immunocompromised, with a median CD4+ cell count of 18 (range: 0-78)/microliters. From 24 patients at least 1 isolate of Cryptococcus neoformans was typed, all being var. neoformans, identical with serotype A/D.
Knudsen
J D
JD
Division of Microbiology, Statens Serum Institut, Copenhagen, Denmark.
Jensen
L
L
Sørensen
T L
TL
Jensen
T
T
Kjersem
H
H
Stenderup
J
J
Pedersen
C
C
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use; D003453:Cryptococcosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006679:HIV Seropositivity; D006801:Humans; D015994:Incidence; D008297:Male; D016919:Meningitis, Cryptococcal / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D008875:Middle Aged
D000935:Antifungal Agents