Tuberculosis/cryptococcosis co-infection in China between 1965 and 2016

Emerg Microbes Infect. 2017 Aug 23;6(8):e73. doi: 10.1038/emi.2017.61.

Abstract

Cases of tuberculosis/cryptococcosis co-infection are rapidly increasing in China. However, most studies addressing this co-infection have been published in Chinese journals, and this publication strategy has obscured this disease trend for scientists in other parts of the world. Our investigation found that 62.9% of all co-infection cases worldwide were reported in the Chinese population (n=197) between 1965 and 2016, and 56.3% of these Chinese cases were reported after 2010. Nearly all cases originated from the warm and wet monsoon regions of China. HIV-positive subjects tended to correlate with more severe manifestations of a tuberculosis/cryptococcosis co-infection than those without HIV. Notablely, dual tubercular/cryptococcal meningitis was the most frequent (54.0%) and most easily misdiagnosed (95.2%, n=40/42) co-infection. We also found that the combined use of cerebrospinal fluid pressure and concentrations of glucose, protein and chlorine might be an inexpensive and effective indicator to differentiate tubercular/cryptococcal co-infection meningitis from tubercular meningitis and cryptococcal meningitis.

Publication types

  • Review

MeSH terms

  • Adult
  • Cerebrospinal Fluid Proteins
  • China / epidemiology
  • Chlorine / cerebrospinal fluid
  • Coinfection / diagnosis
  • Coinfection / epidemiology*
  • Cryptococcosis / complications*
  • Cryptococcosis / epidemiology*
  • Diagnostic Errors
  • Female
  • Glucose / cerebrospinal fluid
  • HIV Infections / complications
  • HIV Infections / epidemiology
  • HIV Infections / virology
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Meningitis, Cryptococcal / complications
  • Meningitis, Cryptococcal / diagnosis
  • Meningitis, Cryptococcal / epidemiology
  • Retrospective Studies
  • Tuberculosis / complications*
  • Tuberculosis / epidemiology*
  • Tuberculosis, Meningeal / complications
  • Tuberculosis, Meningeal / diagnosis
  • Tuberculosis, Meningeal / epidemiology

Substances

  • Cerebrospinal Fluid Proteins
  • Chlorine
  • Glucose