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

Abstract:

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.

journal_name

BMC Infect Dis

journal_title

BMC infectious diseases

authors

Guo LY,Liu LL,Liu Y,Chen TM,Li SY,Yang YH,Liu G

doi

10.1186/s12879-016-1964-6

subject

Has Abstract

pub_date

2016-11-04 00:00:00

pages

635

issue

1

issn

1471-2334

pii

10.1186/s12879-016-1964-6

journal_volume

16

pub_type

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