Table 1.
Characteristics of Patients With Cryptococcal Meningitis
| Characteristics | Total N = 257 (%) |
Shunt N = 44 (%) |
No Shunt N = 213 (%) |
P value |
|---|---|---|---|---|
| Mean age, years (SD) | 47.7 (14.4) | 43.1 (10.0) | 48.6 (15.0) | .02 |
| Age <50 years (%) | 151 (58.8) | 34 (77.3) | 117 (54.9) | .006 |
| Male gender (%) | 184 (71.6) | 25 (56.8) | 159 (74.7) | .02 |
| Black race (%) | 114 (44.4) | 19 (43.2) | 95 (44.6) | .86 |
| Mortality (1 year) (%) | 124 (48.2) | 13 (29.6) | 11 (52.1) | .006 |
| Underlying disease (%) | ||||
| HIV | 109 (42.4) | 18 (40.9) | 91 (42.7) | .82 |
| Solid organ transplant | 76 (29.6) | 7 (15.9) | 69 (32.4) | .03 |
| Non-HIV, non-SOT | 72 (28.0) | 19 (43.2) | 53 (24.9) | .014 |
| Normal host | 29 (11.3) | 13 (29.6) | 16 (7.5) | <.001 |
| Renal insufficiency | 29 (11.3) | 1 (2.3) | 28 (13.2) | .04 |
| Diabetes | 39 (15.2) | 7 (15.9) | 32 (15.0) | .88 |
| Cirrhosis | 15 (5.8) | 0 (0) | 15 (7.0) | .07 |
| Corticosteroids | 88 (34.2) | 9 (20.5) | 79 (37.1) | .03 |
| Cancer | 22 (8.6) | 1 (2.3) | 21 (9.9) | .13 |
| Mean length of symptoms, days (SD) | 31.3 (49.2) | 46.4 (69.6) | 28.2 (43.4) | .02 |
| Clinical presentation (%) | ||||
| Symptoms present >14 days | 124 (48.3) | 25 (56.8) | 99 (46.5) | .21 |
| Malaise | 60 (23.4) | 7 (15.9) | 53 (24.9) | .20 |
| Weight loss | 56 (21.8) | 10 (22.7) | 46 (21.6) | .87 |
| Fever | 97 (37.7) | 13 (29.6) | 84 (39.4) | .22 |
| Headache | 181 (70.4) | 37 (84.1) | 144 (67.6) | .03 |
| Nausea and vomiting | 84 (32.7) | 19 (43.2) | 65 (30.5) | .10 |
| Cranial nerve palsy | 23 (9.0) | 9 (20.5) | 14 (6.6) | .003 |
| Altered mental status | 113 (44.0) | 19 (43.2) | 94 (44.1) | .90 |
| Seizures | 28 (10.9) | 4 (9.1) | 24 (11.3) | .80 |
| Visual changes | 59 (23.0) | 21 (47.7) | 38 (17.8) | <.0001 |
| Baseline diagnostic testing | ||||
| CSF protein, mean (SD) | 135.2 (219.1) | 159.2 (208.1) | 130.1 (221.6) | .44 |
| CSF protein > 125 mg/dl | 66 (25.7) | 12 (29.6) | 53 (24.9) | .51 |
| CSF glucose, mean (SD) | 47.1 (32.2) | 43.0 (27.5) | 48.0 (33.1) | .35 |
| CSF glucose < 20 mg/dl | 55 (21.4) | 10 (22.7) | 45 (21.1) | .81 |
| CSF WBC count, mean (SD) | 117.6 (297.3) | 122.6 (238) | 116.5 (308) | .90 |
| CSF WBC > 100 cells | 59 (23.0) | 11 (25.0) | 48 (22.5) | .72 |
| Opening pressure, mean mm H2O (SD) | 28.4 (16.0) | 41.3 (15.7) | 25.6 (14.6) | <.0001 |
| CSF OP > 25 cm H2O | 98/178 (55.1) | 28/32 (87.5) | 70/146 (48.0) | <.0001 |
| CSF OP > 30 cm H2O | 69/178 (38.8) | 25/32 (78.1) | 44/146 (30.1) | <.0001 |
| Repeated lumbar puncture for increased pressure | 100/251 (39.8) | 28/43 (65.1) | 72/211 (34.1) | .0001 |
| Serum CrAG ≥ 1024 | 70 (27.2) | 10 (22.7) | 60 (28.2) | .46 |
| Serum CrAG, median | 512 | 1024 | 512 | .30 |
| CSF CrAG ≥ 1024 | 71 (27.6) | 12 (27.3) | 59 (27.7) | .95 |
| CSF CrAG, median | 256 | 512 | 256 | .48 |
| Positive baseline CSF culture | 197/244 (80.7) | 35/43 (81.4) | 162/201 (80.6) | .90 |
| Hydrocephalus on baseline imaging | 30/223 (14.3) | 14/41 (34.1) | 16/182 (8.8) | <.0001 |
Abbreviations: CRAG, cryptococcal antigen; CSF, cerebrospinal fluid; OP, opening pressure; SD, standard deviation; SOT, solid organ transplant; WBC, white blood cell.