1. Cryptococcosis in patients with hematological diseases: a 14-year retrospective clinical analysis in a Chinese tertiary hospital.
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Rui-ying Wang, Yan-qiong Chen, Ji-qin Wu, Xuan Wang, Ya-hui Cao, Hua-zhen Zhao, Li-ping Zhu, Wang, Rui-Ying, Chen, Yan-Qiong, Wu, Ji-Qin, Wang, Xuan, Cao, Ya-Hui, Zhao, Hua-Zhen, and Zhu, Li-Ping
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BLOOD diseases ,CRYPTOCOCCOSIS ,MENINGITIS ,AMPHOTERICIN B ,ALTERNATIVE medicine ,TERTIARY care ,PUBLIC health ,PATIENTS ,THERAPEUTICS - Abstract
Background: Cryptococcal infection has become a public health challenge globally. However, information about cryptococcal infection in patients with hematological diseases remains relatively rare.Methods: HIV-uninfected cryptococcosis cases with hematological diseases admitted to Huashan Hospital from January 2001 to December 2014 were reviewed.Results: In total, 33 cryptococcosis patients were enrolled, including 12 malignant and 21 non-malignant hematological cases. Twenty-six patients had central nervous system (CNS) involvement, which was observed more often in patients with non-malignancies than with malignancies (20/21 vs. 6/12, P = 0.001) Most patients (25/26) with CNS infection were confirmed by cerebrospinal fluid (CSF) culture or smear, and 100% (20/20) of them tested positive for the CSF cryptococcal antigen test. Eighteen out of 26 cryptococcal meningitis patients were treated with amphotericin B (AmB)-based therapy, 16 of them with AmB deoxycholate (d-AmB) and 2 patients with liposomal AmB. The clinical success rate was 55.6%. D-AmB was well-tolerated at 0.35-0.59 mg/kg/d (median 0.43 mg/kg/d) and only 12 patients had mild adverse events.Conclusions: CNS cryptococcal infection was more frequent in patients with hematological non-malignancies, and cryptococcal antigen test as well as the CSF fungal culture or smear are suggested for early diagnosis. D-AmB could be used as an alternative therapy for CNS-infected patients with hematological diseases. [ABSTRACT FROM AUTHOR]- Published
- 2017
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