Table 1.
Features of 35 cryptococcal meningitis cases according to infecting species.
| C. neoformans var grubii | C. neoformans var gattii | ||||
|---|---|---|---|---|---|
| (n = 25) | (n = 10) | ||||
| Variable | Value | Value | Odds ratio | P Value | |
| (Range or %) | (range or %) | (95% CI) | |||
| Median Age (range) | 31 (15 - 74) | 41 (18 - 53) | 0.47 | ||
| Male Sex | 10 (40) | 5 (50) | 1.48 (0.26 - 8.4) | 0.71 | |
| Underlying Disease | 7 (28) | 1 (10) | 0.29 (0.01 - 2.9) | 0.39 | |
| Symptoms | |||||
| Fever | 20 (80) | 9 (90) | 2.2 (0.2 - 117) | 0.64 | |
| Headache | 19 (90) | 8 (89) | 0.85 (0.04 - 55.8) | 1.0 | |
| Vomiting | 9 (36) | 5 (50) | 1.75 (0.31 - 10.1) | 0.47 | |
| Blurred vision | 12 (52) | 4 (40) | 0.62 (0.10 - 3.47) | 0.71 | |
| Diplopia | 4 (20) | 2 (20) | 1.0 (0.95 - 10.9) | 1.0 | |
| Convulsions | 4 (16) | 1 (10) | 0.59 (0.01 - 7.2) | 0.59 | |
| Signs | |||||
| GCS < 11/15 | 7 (28) | 1 (10) | 0.29 (0.01 - 2.9) | 0.39 | |
| Neck Stiffness | 22 (88) | 8 (80) | 0.56 (0.05 - 7.8) | 0.61 | |
| Focal Neurological Signs | 7 (28) | 5 (50) | 2.5 (0.4 - 15.0) | 0.26 | |
| Papilloedema | 5 (21) | 5 (50) | 3.63 (0.6 - 24.3) | 0.11 | |
| Investigations | |||||
| Abnormal Chest X-ray | 8 (32) | 2 (20) | 0.54 (0.05 - 3.7) | 0.69 | |
| Abnormal Brain Imaginga | 7 (58) | 7(100) | - | 0.13 | |
| Haematocrit | 37.8 (25.3 - 51.4) | 38.8 (31.1 - 46) | 0.65 | ||
| Blood White Cell Count (×10^9/ml) | 11.5(3.3 - 26.6) | 13.6 (7.1 - 26.1) | 0.37 | ||
| Platelet count (×10^9/L) | 256 (56.9 - 356) | 305 (140 - 487) | |||
| CSF opening pressure (cmCSF)b | 34.2 (2 - > 40) | 30.5 (15 - > 40) | 0.44 | ||
| CSF White Cell Count/ml | 287 (2 - 1080) | 279 (12 - 480) | 0.18 | ||
| CSF Lymphocyte %c | 53 (12 - 97) | 56 (19 - 93) | 0.74 | ||
| CSF Protein (g/L) | 1.28 (0.35 - 2.63) | 1.25 (0.4 - 1.94) | 0.9 | ||
| Log2 CSF Cryptococcal antigen titre5 | 7.4 (3 - 15) | 8.6 (2 - 14) | 0.5 | ||
| Lactate (mmol/L) | 6.2 (1.6 - 22.5) | 4.2 (2 - 8.4) | 0.052 | ||
| Antifungal MICs (mg/L) | |||||
| Amphotericin | GM(95%CI) | 0.71 (0.62 - 0.83) | 0.45 (0.34 - 0.60) | 0.01 | |
| MIC90 | 1.0 | 0.5 | |||
| Flucytosine | GM(95%CI) | 8.23 (7.22 - 9.37) | 1.85 (1.18 - 2.90) | < 0.001 | |
| MIC90 | 16/0 | 4.0 | |||
| Fluconazole | GM(95%CI) | 6.96 (5.11 - 9.49) | 4.54 (2.44 - 8.42) | 0.19 | |
| MIC90 | 16.0 | 16.0 | |||
| Itraconazole | GM(95%CI) | 0.11 (0.08 - 0.14) | 0.9 (0.05 - 0.14) | 0.48 | |
| MIC90 | 0.26 | 0.26 | |||
| Voriconazole | GM(95%CI) | 0.07 (0.05 - 0.09) | 0.06 (0.04 - 0.51) | 0.85 | |
| MIC90 | 0.13 | 0.26 | |||
| Posaconazole | GM(95%CI) | 0.13 (0.10 - 0.17) | 0.10 (0.06 - 0.17) | 0.336 | |
| MIC90 | 0.26 | 0.26 | |||
aN = 26, bN = 33, cN = 32, dN = 31
GM = Geometric Mean
MIC90 = minimum inhibitory concentration 90