PMID- 32561831
OWN - NLM
STAT- MEDLINE
DCOM- 20201207
LR  - 20210619
IS  - 2045-2322 (Electronic)
IS  - 2045-2322 (Linking)
VI  - 10
IP  - 1
DP  - 2020 Jun 19
TI  - Clinical and Radiographic Features of Cryptococcal Neoformans 
      Meningitis-associated Immune Reconstitution Inflammatory Syndrome.
PG  - 9948
LID - 10.1038/s41598-020-67031-4 [doi]
LID - 9948
AB  - Cryptococcal meningitis is the most common intracranial infectious fungal 
      disease. After a period of antifungal treatment, as the number of cells in the 
      cerebrospinal fluid decreases, the biochemical indexes improve and the number of 
      cryptococcus reduces, the patient's condition suddenly worsen. Most of the 
      symptoms are severe headache, raised intracranial pressure, together with 
      impaired clinical nerve function. These presentations are often mistaken for a 
      failure of antifungal treatment. In fact it's an encephalitis syndrome which is 
      unrecognized by most clinicians: Immune reconstitution inflammatory syndrome 
      (IRIS). To increase awareness we retrospectively analyzed clinical data of 100 
      cases of cryptococcal neoformans meningitis, among which 26 patients develop 
      CM-IRIS. All patients have been divided into three groups: Group 1, patients who 
      were not treated with glucocorticoid and didn't experienced IRIS; Group 2, 
      patients who were not treated with glucocorticoid although developed CM-IRIS; 
      Group 3, patients started treatment with glucocorticoid for two weeks with new 
      onset CM-IRIS. Compared with the group treated with glucocorticoid, treatment 
      without glucocorticoid was subjected to a higher risk of incident IRIS. The 
      difference was statistically significant (P < 0.05). Imaging findings 
      demonstrated diseased area of the white matter area, and it looked like commonly 
      in the supratentorial region. Moreover, if it appears in the infratentorial 
      region then must be combined with supratentorial region.
FAU - Wu, Gang
AU  - Wu G
AD  - Professor, Department of Neurology, The First Affiliated Hospital of Fujian 
      Medical University, Fuzhou, Fujian, P.R. China. gangwu57@hotmail.com.
FAU - Guo, Xiumei
AU  - Guo X
AD  - Department of Neurology, Fujian Provincial Geriatric Hospital; Department of 
      Neurology, North Hospital of Fujian Provincial Hospital, Fuzhou, Fujian, P.R. 
      China.
FAU - Wang, Yan
AU  - Wang Y
AD  - Department of Neurology, First Hospital of Quanzhou, Fujian Province, Quanzhou, 
      Fujian, P.R. China.
FAU - Hu, Zhijian
AU  - Hu Z
AD  - Department of Epidemiology and Statistics, School of Public Health, Fujian 
      Medical University, Fuzhou, Fujian, P.R. China.
LA  - eng
PT  - Journal Article
DEP - 20200619
PL  - England
TA  - Sci Rep
JT  - Scientific reports
JID - 101563288
RN  - 0 (Glucocorticoids)
SB  - IM
MH  - Adult
MH  - Cryptococcus neoformans/pathogenicity
MH  - Female
MH  - Glucocorticoids/administration & dosage/adverse effects/therapeutic use
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/diagnostic 
      imaging/epidemiology/*etiology/pathology
MH  - Male
MH  - Meningitis, Cryptococcal/*complications/drug therapy/microbiology
MH  - Middle Aged
MH  - White Matter/diagnostic imaging
PMC - PMC7305181
COIS- The authors declare no competing interests.
EDAT- 2020/06/21 06:00
MHDA- 2020/12/15 06:00
PMCR- 2020/06/19
CRDT- 2020/06/21 06:00
PHST- 2019/04/29 00:00 [received]
PHST- 2020/05/26 00:00 [accepted]
PHST- 2020/06/21 06:00 [entrez]
PHST- 2020/06/21 06:00 [pubmed]
PHST- 2020/12/15 06:00 [medline]
PHST- 2020/06/19 00:00 [pmc-release]
AID - 10.1038/s41598-020-67031-4 [pii]
AID - 67031 [pii]
AID - 10.1038/s41598-020-67031-4 [doi]
PST - epublish
SO  - Sci Rep. 2020 Jun 19;10(1):9948. doi: 10.1038/s41598-020-67031-4.