Abstract
BackgroundMany neurological diseases are accompanied by an increase in the cerebrospinal fluid (CSF) protein concentration, which indicates dysfunction of the blood-CSF/blood–brain barrier. However, the significance CSF protein concentration of patients with cryptococcal meningitis (CM) is not fully understood. The aim of the present was to determine whether CSF protein concentrations correlated with the responses of patients to treatment with antifungal drugs.MethodsWe conducted a retrospective study of the analytical data of 623 lumbar punctures of 46 patients with CM who were treated at West China Hospital. We divided the patients into groups with good or poor responses to antifungal treatment. We used a generalized linear mixed model (GLMM) to evaluate the significance of the differences between the two groups.ResultsThe baseline CSF protein concentrations of the good antifungal response group (GR-group) (median = 0.97 g/L) were higher compared with those of the poor antifungal response group (PR-group) (median = 0.72 g/L). Analysis using the GLMM indicated that the CSF protein concentration of the GR-group decreased at a rate of 1.8 mg/L per day after antifungal treatment started and was 2.1 mg/L higher compared with that of the PR-group.ConclusionsCompared with poor responders, we found that the baseline CSF protein concentrations of good responders were higher and decreased at faster rate after the initiation of antifungal treatment.
Highlights
Many neurological diseases are accompanied by an increase in the cerebrospinal fluid (CSF) protein concentration, which indicates dysfunction of the blood-CSF/blood–brain barrier
To achieve a better outcome, most patients receive treatment that includes amphotericin B (AMB) [17]; we found that the implementation of antifungal strategies varied because of practical considerations such as costs, side effects, and availability of drugs
A plausible hypothesis to explain the data is that the intensity of the inflammatory response influences the antifungal response, and the CSF protein concentrations represent the intensity of inflammatory responses
Summary
Many neurological diseases are accompanied by an increase in the cerebrospinal fluid (CSF) protein concentration, which indicates dysfunction of the blood-CSF/blood–brain barrier. The significance CSF protein concentration of patients with cryptococcal meningitis (CM) is not fully understood. The aim of the present was to determine whether CSF protein concentrations correlated with the responses of patients to treatment with antifungal drugs. Cryptococcal meningitis (CM) caused by Cryptococcus neoformans and Cryptococcus gattii [1] is notorious for prolonged treatment and high mortality [2,3,4]. There are reports of immunocompetent patients infected with C. neoformans [6,7,8]. This disease imposes a great burden worldwide, in sub-Saharan Africa [3]. Analyses of the cerebral spinal fluid (CSF) of patients with CM patients provide a wealth of clinical data acquired through the use
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
