Table 1.
Clinical characteristics in cases of Cryptococcus infection
| Patient characteristics | Number | Total Count (%) |
Count (%), Median (IQR) | |
|---|---|---|---|---|
| Non-CNS (n=20) | CNS (n=30) | |||
| Demographics | ||||
| Gender (Male) | 50 | 41 (82%) | 14 (70%) | 27 (90%) |
| Race (White) | 48 | 32 (67%) | 13 (68%) | 19 (66%) |
| Age | 51 | 53.6 (21.6) | 60.2 (15.9) | 48.2 (25) |
| Occupation (outdoor) | 26 | 14 (54%) | 6 (67%) | 8 (47%) |
| Symptoms | ||||
| Constitutional | 50 | 33 (66%) | 11 (55%) | 22 (76%) |
| Headaches | 50 | 18 (36%) | 1 (5%) | 17 (59%) |
| AMS | 50 | 10 (20%) | 1 (5%) | 9(31%) |
| Respiratory | 50 | 22 (45%) | 14 (70%) | 8 (28%) |
| Other Symptoms | 50 | 15 (30%) | 3 (15%) | 12 (41%) |
| Fever | 47 | 11 (23%) | 2 (11%) | 9 (32%) |
| Past medical history | ||||
| Smoking (Former and current) | 48 | 25 (52%) | 9 (47%) | 16 (55%) |
| Lung disease | 50 | 10 (20%) | 7 (35%) | 3 (10%) |
| DM2 | 50 | 8 (16%) | 4 (20%) | 4 (13%) |
| Malignancy | 50 | 14 (28%) | 10 (50%) | 4 (13%) |
| Sarcoidosis | 50 | 1 (2%) | 0 (0%) | 1 (3%) |
| Cirrhosis | 50 | 5 (10%) | 2 (10%) | 3 (10%) |
| HIV | 50 | 23 (46%) | 5 (26%) | 17 (57%) |
| Transplant | 49 | 9 (18%) | 4 (21%) | 5 (17%) |
| Steroid | 49 | 14 (29%) | 4 (21%) | 10 (33%) |
| Prednisone dose (mg) | 13 | 12.5 (10) | 20 (40) | 11.25 (7.5) |
| CNI | 49 | 7 (14%) | 3 (16%) | 4 (13%) |
| HIV and Transplant | ||||
| Time since HIV Diagnosis (y) | 20 | 5.9 (17.7) | 5.1 (6.6) | 9 (18.5) |
| HIV resistance | 6 | 3 (50%) | 1 (100%) | 3 (60%) |
| HAART | 22 | 6 (12%) | 1 (5%) | 5 (17%) |
| Time since HAART (y) | 12 | 0 (0.3) | 0 (4.1) | 0 (0.4) |
| Viral load (103 copies/ml) | 19 | 81 (211) | 39 (187) | 83 (137) |
| Type of SOT (Kidney) | 10 | 6 (60%) | 2 (40%) | 4 (80%) |
| Time since Transplant (y) | 9 | 1.1 (1.3) | 0.9 (1.2) | 1.1 (3.2) |
| CD4 (cells/µL) | 24 | 56 (117) | 14 (92) | 60 (123) |
| Laboratory data | ||||
| WBC (4.0–11.1 × 109/L) | 50 | 6.1 (4.5) | 5.9 (4.3) | 6.5 (4.5) |
| Hemoglobin (14.3–18.1 g/dl) | 50 | 11.9 (4.5) | 12.2 (3.9) | 11.2 (3.3) |
| Platelets (150–400 × 109/L) | 50 | 193 (165) | 216.5 (98) | 165 (179) |
| Lymphocytes (1.0–4.8 × 109/L) | 48 | 0.9 (1) | 0.9 (0.8) | 0.8 (1.8) |
| Monocytes (0.2–0.9 × 109/L) | 48 | 0.4 (0.5) | 0.5 (0.4) | 0.4 (0.6) |
| Neutrophil (1.8–6.6 × 109/L) | 48 | 3.6 (3.3) | 4.2 (3.1) | 3.6 (3.5) |
| Eosinophil (0.0–0.4 × 109/L) | 48 | 0 (0.1) | 0 (0.1) | 0 (0.1) |
| Na (133–145 mmol/L) | 49 | 135 (6) | 137 (5) | 135 (6) |
| Creatinine (0.7–1.3 mg/dl) | 49 | 1 (0.7) | 0.9 (0.4) | 1.2 (0.8) |
| Baseline Creatinine | 49 | 1 (0.3) | 0.9 (0.1) | 1.1 (0.6) |
| Corrected Ca (8.6–10.3 mg/dl) | 47 | 9.4 (0.8) | 9.3 (0.7) | 9.5 (0.8) |
| Albumin (3.5–5.7 g/dl) | 47 | 3.1 (1) | 2.8 (1.4) | 3.2 (0.8) |
| Alk. Phosphatase (39–117 U/L) | 46 | 68.5 (35) | 68.5 (30) | 68 (39) |
| AST (12–39 U/L) | 46 | 25.5 (17) | 26 (11) | 25 (25.5) |
| ALT (7–52 U/L) | 46 | 24 (21) | 22 (11) | 24.5 (25) |
| Total Bilirubin (0.1–1.3 mg/dl) | 46 | 0.7 (0.7) | 0.7 (0.6) | 0.7 (0.8) |
| Opening Pressure (<20 cm H2O) | 16 | 24 (23) | 13.5 (0) | 24 (23) |
| Serum cryptococcal antigen | 39 | 26 (67%) | 6 (35%) | 20 (91%) |
| CSF cryptococcal antigen | 24 | 20 (67%) | NA | 20 (83%) |
| Blood culture | 41 | 16 (39%) | 1 (7%) | 14 (54%) |
| CSF Culture | 25 | 18 (58%) | NA | 18 (72%) |
| CSF WBC (0–5 × 106/L) | 31 | 35 (130) | 1 (3) | 57 (150) |
| CSF PMN (0–2 × 106/L) | 31 | 1.5 (32.5) | 0 (0) | 5.9 (42.8) |
| CSF LYM (0–4 × 106/L) | 31 | 10.7 (31.9) | 0.7 (2.4) | 20.6 (32.4) |
| CSF MONO (0–2 × 106/L) | 31 | 1.8 (34.5) | 0.1 (0.6) | 7.6 (36) |
| CSF glucose (40–70 mg/dl) | 30 | 42.5 (21) | 62 (30) | 39.5 (20.5) |
| CSF protein (15–45 mg/dl) | 31 | 66 (84) | 40 (10) | 89 (82) |
| Outcomes | ||||
| IRS | 49 | 5 (10%) | 2 (11%) | 3 (10%) |
| Treatment (AF) | 47 | 24 (51%) | 1 (6%) | 23 (79%) |
| Death | 49 | 16 (33%) | 7 (37%) | 9 (30%) |
| Attributable death | 49 | 9 (18%) | 1 (5%) | 8 (27%) |
| Cognitive deficits | 42 | 10 (24%) | 0 (0%) | 10 (42%) |
| VPS | 43 | 2 (5%) | 0 (0%) | 2 (8%) |
| New onset | 50 | 44 (88%) | 20 (100%) | 24 (80%) |
| Relapse | 36 | 5 (14%) | 0 (0%) | 5 (21%) |
*
CNS: Central nervous system; AMS: altered mental status; DM2, diabetes mellitus type 2, CNI: calcineurin inhibitors; y: years; HAART: highly active antiretroviral therapy, SOT: solid organ transplant; CSF: cerebrospinal fluid; IRS: immune reconstitution syndrome; AF: Amphotericin B plus Flucytosine; VPS: ventriculoperitoneal shunt