Characteristics and outcomes of cryptococcal meningitis in HIV seronegative children in Beijing, China, 2002-2013.
Data regarding HIV-seronegative pediatric patients with cryptococcal meningitis (CM) have been very limited.



We retrospectively reviewed non-HIV-infected in patients with CM from January 2002 through December 2013 in Beijing Children's Hospital. Records of the all patients were obtained and compared.



The 34 children had a median age of 5.6 years. Most of the patients were male (67.6 %). Only 23.5 % of the cases had identifiable underlying diseases. The sensitivity of the CSF cryptococcal antigen, India ink smear and CSF culture in our study were 81.5, 85.3 and 82.4 %, respectively. And the sensitivity of combinations of these tests was 91.2 %. Out of the 34 patients, 16 (47.1 %) had other organs involvement in addition to the brain. The main abnormal features via magnetic resonance imaging (MRI) were Virchow-Robin space dilatation (44.4 %), hydrocephalus (38.9 %), gelatinous pseudocysts (33.3 %), brain atrophy (33.3 %), meningeal enhancement (27.8 %) and local lesions (27.8 %). In total, 64.7 % of the patients were successfully treated at discharge, whereas treatment failed in 35.3 % of the patients.



Cryptococcal meningitis is an infrequent disease with a high fatality rate in children in China. The majority of patients were apparently healthy. Clinicians should consider cryptococcal infection as a potential pathogen of pediatric meningitis. Cryptococcal antigen, India ink smear and culture tests are recommended for diagnosis.
Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, Beijing, China.|Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics (Capital Medical University), Ministry of Education, National Clinical Research Centre for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China.
Ling-Yun
LY
Guo
Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, Beijing, China.
Lin-Lin
LL
Liu
Department of Radiology, Beijing Children's Hospital, Capital Medical University, Beijing, China.
Yue
Y
Liu
Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, Beijing, China.
Tian-Ming
TM
Chen
Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, Beijing, China.
Shao-Ying
SY
Li
Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics (Capital Medical University), Ministry of Education, National Clinical Research Centre for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, China. yyh628628@sina.com.
Yong-Hong
YH
Yang
Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, Beijing, China. liugangbch@sina.com.
Gang
G
Liu
D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D018023:HIV Seronegativity; D006801:Humans; D007121:Immunocompetence; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D016919:Meningitis, Cryptococcal / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies