Abstract
BackgroundData regarding HIV-seronegative pediatric patients with cryptococcal meningitis (CM) have been very limited.MethodsWe 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.ResultsThe 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.ConclusionsCryptococcal 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.
Highlights
Data regarding Human immunodeficiency virus (HIV)-seronegative pediatric patients with cryptococcal meningitis (CM) have been very limited
Study population We retrospectively reviewed non-HIV-infected in patients with CM from January 2002 through December 2013 in Beijing Children’s Hospital (a 970-bed tertiary health care hospital), China
Overall, 34 HIV-negative children with CM were enrolled in this study
Summary
Data regarding HIV-seronegative pediatric patients with cryptococcal meningitis (CM) have been very limited. Cryptococcal meningitis (CM) is the most common fungal infection of the central nervous system and has a high morbidity and mortality. Approximately 957,900 cases of CM occur annually, resulting in 624,700 deaths within 3 months after infection [1]. Many large studies have been conducted in adults, but few studies have been dedicated to pediatric patients. On the basis of these limited data, the incidence of cryptococcosis in children was 0.016–100 cases/100,000 children [2]. The average annual incidence of CM was found to be 0.43/100,000 in China [3].
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