Clinical features and para-clinical findings of cryptococcal meningitis in the North of Iran during ۲۰۱۱-۱۹

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نوع سند: مقاله ژورنالی
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شناسه ملی سند علمی:

JR_CUMM-6-4_007

تاریخ نمایه سازی: 9 آذر 1402

Abstract:

Background and Purpose:Cryptococcalmeningitis (CM) is a serious fungal infection that especially affectspatients with human immunodeficiency virus (HIV). In this regard,the presentretrospective study aimed to analyze the clinical and laboratory features and therapeutic outcomes of patients with CM admitted totwo teaching referral centersin the north of Iran during ۲۰۱۱-۱۹. Materials and Methods:This studywas performed onall the hospitalized patients diagnosedwith CM in two therapeutic centers of infectious diseases in the north of Iran. The required data,such as demographic characteristicsandclinical and paraclinical featuresof patients,were extracted and entered in the information forms. Finally, the collected data were analyzed inSPSSsoftware(version۱۶). Results:For the purpose of the study, records of ۱۲confirmed CM patients were evaluatedin this research. Based onthe results,۷۵% ofthepatients were male.Moreover,the average age of the subjectswas ۴۰.۳۳± ۸.۹۳ years oldand ۶۶.۶%ofthem(n=۸) were HIV-positive. Other underlying diseases among HIV-positive patients includedinfection with hepatitis C virus (۲۵%) and a history of tuberculosis (۲۵%). In total, threeHIV-negative patients suffered from Hodgkin lymphoma (۲۵%), sarcoidosis (۲۵%),and asthma (۲۵%) and one patient (۲۵%) had no underlying disease. Headache (۷۵%), weakness,and fatigue (۷۵%) were the most common symptomsamong the participants. The cluster of differentiation ۴count in all HIV-positive patients was less than ۱۰۰ cells/μl. There was no significant difference between symptoms in HIV-positive and HIV-negative patients. Besides, no significant differencewas observedbetween the groups of HIV-positive and HIV-negative patientsregardingthe period betweentheonset of symptoms and diagnosisof CM,the length of hospital stay,and the duration of antifungal medicationconsumption. In total,threepatients (۲۵%) expired,and six patients recovered. The CM recurred in two HIV-negative and oneHIV-positivesubjects;the two HIV-negativepatientswere treated,whilethe HIV-positivepatientexpired due to thisrecurrence. Conclusion:Clinical features and cerebrospinal fluid parameters were not different in HIV-positive and HIV-negative participants. Despite the fact thatCM is not commoninIran, due to the increasing number of immunosuppressive patients, the differential diagnosis of CM should be considered forpatients with signs and symptoms of infection in the central nervous system.

Authors

Farhang Babamahmoodi

Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran

Kobra Gerizade firozjaii

Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran

Masoumeh Bayani

Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran

Tahereh Shokohi

Invasive Fungi Research Center, communicable diseaes institue,Mazandaran University of Medical Sciences, Sari, Iran.

Jamshid Yazdani

Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran

Amir Mohammad Beyzaee

Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran

Fatemeh Ahangarkani

Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran

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