Table 5.
Therapeutic regimen and treatment outcome of 136 patients with pulmonary cryptococcosis.
| Variables | Immunocompromised Patients (N = 94)(n,%) | Immunocompetent Patients (N = 42)(n,%) | P-value | Improved outcome | P-value | |
|---|---|---|---|---|---|---|
| Time from onset of symptoms to treatment/diagnosis (d) | Immunocompromised Patients (n,%) | Immunocompetent Patients (n,%) | ||||
| 0–30 | 38 (40.4) | 15 (35.7) | 0.859 | 19 (19/38, 50.0) | 15 (15/15, 100.0) | 0.000 |
| 31–90 | 33(35.1) | 15 (35.7) | 20 (20/33, 60.6) | 15 (15/15, 100.0) | 0.004 | |
| 91–180 | 14 (14.9) | 6 (14.3) | 7 (7/14, 50.0) | 6 (6/6, 100.0) | 0.051 | |
| >180 | 9 (9.6) | 6 (14.3) | 5 (5/9, 55.6) | 6 (6/6, 100.0) | NA | |
| Time from onset of symptoms to treatment/diagnosis (d) (CNS non-involvement) | ||||||
| N = 48 | N = 38 | |||||
| 0–30 | 14 (29.2) | 14 (36.8) | 0.871 | 9 (9/14, 64.3) | 14 (14/14, 100.0) | 0.041 |
| 31–90 | 20 (41.7) | 13 (34.2) | 17 (17/20, 85.0) | 13 (13/13, 100.0) | 0.261 | |
| 91–180 | 6 (15.0) | 5 (13.2) | 4 (4/6, 66.7) | 5 (5/5, 100.0) | 0.455 | |
| å 180 | 8 (16.6) | 6 (15.8) | 4 (4/8, 50.0) | 6 (6/6, 100.0) | NA | |
| Time from onset of symptoms to treatment/diagnosis (d) (CNS involvement) | ||||||
| N = 46 | N = 4 | |||||
| 0–30 | 24 (52.2) | 1 (25.0) | 0.620 | 10 (10/24, 41.7) | 1 (1/1, 100.0) | NA |
| 31–90 | 12 (26.1) | 2 (50.0) | 3 (3/12, 25.0) | 2 (2/2, 100.0) | ||
| 91–180 | 7 (15.2) | 1 (25.0) | 3 (3/7, 42.9) | 1 (1/1, 100.0) | ||
| å 180 | 3 (6.5) | 0 (0.0) | 1 (1/3, 33.3) | 0 | ||
| Treatment | ||||||
| No treatment | 9 (9.6) | 0 (0.0) | 0.000 | 1 (1/9, 11.1) | 0 | NA |
| Surgery | 2 (2.1) | 1 (2.4) | 1 (1/2, 50.0) | 1 (1/1, 100.0) | NA | |
| Antifungal drugs | 78 (83.0) | 26 (61.9) | 50 (50/78, 64.1) | 26 (26/26, 100.0) | 0.000 | |
| Surgery + antifungal drugs | 5 (5.3) | 15 (35.7) | 5 (5/5, 100.0) | 15 (15/15, 100.0) | NA | |
| Treatment (CNS involvement) | ||||||
| N = 46 | N = 4 | |||||
| No treatment | 8 (17.4) | 0 (0.0) | NA | 0 | 0 | NA |
| Surgery | 0 (0.0) | 0 (0.0) | 0 | 0 | ||
| Antifungal drugs | 37 (80.4) | 4 (100.0) | 22 (22/37, 59.5) | 4 (4/4, 100.0) | ||
| Surgery + antifungal drugs | 1 (2.2) | 0 (0.0) | 1 (1/1, 100.0) | 0 | ||
| Treatment (CNS non-involvement) | ||||||
| N = 48 | N = 38 | |||||
| No treatment | 1 (2.1) | 0 (0.0) | 0.006 | 1 (1/1, 100.0) | 0 | NA |
| Surgery | 2 (4.2) | 1 (2.6) | 1 (1/2, 50.0) | 1 (1/1, 100.0) | NA | |
| Antifungal drugs | 41 (85.4) | 22 (57.9) | 28 (28/41, 68.3) | 22 (22/22, 100.0) | 0.002 | |
| Surgery + antifungal drugs | 4 (8.3) | 15 (39.5) | 4 (4/4, 100.0) | 15 (15/15, 100.0) | NA | |
| Antifungal treatment (CNS involvement) | ||||||
| N = 38 | N = 4 | |||||
| FCZ | 4 (10.5) | 0 (0.0) | NA | 0 | 0 | NA |
| VCZ | 0 (0.0) | 0 (0.0) | 0 | 0 | ||
| Itraconazole | 0 (0.0) | 0 (0.0) | 0 | 0 | ||
| AmB + 5-FC | 6 (15.8) | 1 (25.0) | 2 (2/6, 33.3) | 1 (1/1, 100.0) | ||
| AmB + FCZ/VCZ | 8 (21.1) | 0 (0.0) | 5 (5/8, 62.5) | 0 | ||
| FCZ/VCZ + 5-FC | 4 (10.5) | 1 (25.0) | 2 (2/4, 50.0) | 1 (1/1, 100.0) | ||
| AmB + FCZ/VCZ + 5-FC | 16 (42.1) | 2 (50.0) | 11 (11/16, 68.8) | 2 (2/2, 100.0) | ||
| Antifungal treatment (CNS non-involvement) | ||||||
| N = 45 | N = 37 | |||||
| FCZ | 29 (64.4) | 30 (81.1) | NA | 24 (24/29, 82.8) | 30 (30/30, 100.0) | 0.024 |
| VCZ | 5 (11.1) | 5 (13.5) | 4 (4/5, 80.0) | 5 (5/5, 100.0) | NA | |
| Itraconazole | 3 (6.7) | 1 (2.7) | 2 (2/3, 66.7) | 1 (2/2, 100.0) | NA | |
| AmB + 5-FC | 0 (0.0) | 0 (0.0) | 0 | 0 | NA | |
| AmB + FCZ/VCZ | 5 (11.1) | 0 (0.0) | 3 (3/5, 60.0) | 0 | NA | |
| FCZ/VCZ + 5-FC | 2 (4.4) | 1 (2.7) | 1 (1/2, 50.0) | 1 (1/1, 100.0) | NA | |
| AmB + FCZ/VCZ + 5-FC | 1 (2.2) | 0 (0.0) | 1 (1/1, 100.0) | 0 | NA | |
| Outcome | ||||||
| Improved | 53 (56.4) | 42 (100.0) | 0.000 | |||
| Failure | 41 (43.6) | 0 (0.0) | ||||
AmB: amphotericin B; FCZ: fluconazole; VCZ: voriconazole; 5-FC: 5 fluorocytosine; NA:not applied.