Characteristics and outcomes of cryptococcal meningitis in HIV seronegative children in Beijing, China, 2002-2013.

Background: Data regarding HIV-seronegative pediatric patients with cryptococcal meningitis (CM) have been very limited. Methods: 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. Results: 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. Conclusions: 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. [ABSTRACT FROM AUTHOR]