[Factors associated with mortality in cryptococcal meningitis].
OBJECTIVE
To investigate factors associated with mortality in non-AIDS patients with cryptococcal meningitis.


METHODS
We retrospectively reviewed 154 cases of non-HIV cryptococcal meningitis in a tertiary care hospital in China, from 1997 through 2007.


RESULTS
The 1-year attributable mortality was 19.6% (28/143), and overall mortality was 28.7% (41/143). Advanced age (> or = 60 years), delay in diagnosis (> 4 months), hematologic malignancy, solid malignancy, altered mental status (coma, seizure, herniation), and CSF drainage or shunting were factors associated with increased death; factors associated with increased survival were amphotericin B based initial therapy and flucytosine containing therapy. In multivariate analysis, age > or = 60 years, the time from symptom onset to diagnosis > 4 months, coma, cerebral herniation, and non-amphotericin B based initial therapy were independently associated with increased overall mortality; factors independently associated with cause-specific mortality were time from symptom onset to diagnosis > 4 months, cerebral herniation and non-amphotericin B based initial therapy.


CONCLUSIONS
A variety of factors were associated with mortality in non-AIDS cryptococcal meningitis. Amphotericin B based initial treatment was independently correlated to improved 1-year survival.
Wu
Ji-qin
JQ
Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China.
Xu
Bin
B
Ou
Xue-ting
XT
Zhu
Li-ping
LP
Weng
Xin-hua
XH
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D016919:Meningitis, Cryptococcal / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult