Autoimmune diseases in HIV-negative cryptococcal meningitis

Future Microbiol. 2021 Nov:16:1251-1259. doi: 10.2217/fmb-2020-0318. Epub 2021 Oct 22.

Abstract

Aim: The purpose of our study was to assess the differences between HIV-negative cryptococcal meningitis (CM) patients with and without autoimmune diseases. Methods: A total of 43 CM patients with autoimmune diseases and 67 without autoimmune diseases were enrolled for analysis. Results: CM patients with autoimmune diseases had higher fever, modified Rankin Scale scores, C-reactive protein and erythrocyte sedimentation rate, but had lower rates of visual and hearing symptoms, ventriculoperitoneal shunts, MRI meningeal enhancement and amphotericin B treatment, as well as lower cerebrospinal fluid pressure and fungal counts. When divided according to gender, each group had lower intracranial pressure and higher inflammation indicators. No differences in outcomes, sequelae and mortality hazard were found. Fluconazole treatment was a prognostic factor for CM without autoimmune diseases. Conclusions: Both antifungal and anti-inflammatory therapy should be considered in CM patients with autoimmune diseases.

Keywords: SLE; autoimmune diseases; cryptococcal meningitis; non-HIV; systemic lupus erythematosus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antifungal Agents / therapeutic use
  • Autoimmune Diseases* / complications
  • Fluconazole / therapeutic use
  • HIV Infections
  • Humans
  • Meningitis, Cryptococcal* / diagnosis
  • Meningitis, Cryptococcal* / drug therapy

Substances

  • Antifungal Agents
  • Fluconazole