Table 1.
Epidemiological and laboratory features of HIV-negative patients with cryptococcosis hospitalized in the period of time between July 2016 and June 2019 at the Tropical Medicine Foundation Dr. Heitor Vieira Dourado (Manaus-Amazonas-Brazil)
| Anonymized patient number | |||||||
|---|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | |
| Gender | M | F | F | M | F | F | M |
| Age (in years) | 50 | 23 | 41 | 25 | 52 | 10 | 53 |
| Initial symptoms (before diagnosis) | Headache, fever, vomiting, ocular pain, asthenia, photophobia, weight loss | Headache, photophobia, nausea, vomiting, diplopia, irritability | Headache, stiff neck, vomiting, photophobia, night sweats, face palsy, weight loss | Headache, stiff neck, fever, seizure, photophobia, weight loss | Headache, seizure, photophobia, ocular pain, stiff neck, lethargy | Headache, fever, vomiting, hyporexia, weight loss, asthenia | Headache, fever, vomiting, hyporexia, asthenia, weight loss |
| Symptoms developed during the hospitalization | Intestinal constipation, decrease of consciousness, spikes of HBP, weight loss | Paresis IM, seizures, decrease of consciousness | Intestinal constipation, seizures, anemia, delirium, asthenia, weight loss | Decrease of consciousness, paresis ISM, dysphagia, anemia, dysarthria, fever, peripheral neuropathy | Intestinal constipation, decrease of consciousness, tongue palsy, seizures | Intestinal constipation, seizures, delirium, strabismus | Decrease of consciousness, stroke, delirium, weight loss |
| Duration of initial symptoms until diagnosis (days) | 180 | 150 | 30 | 15 | 730 | 90 | 15 |
| Occupation | Construction worker | Housewife | Teacher | Farmer | Housewife | Student | Commercial manager |
| Medical history | Depression, pericardial tuberculosis | – | Ganglion tuberculosis | Malaria (5 times) | – | – | – |
| Comorbidities | – | Hypertension | Intestinal tuberculosis | – | Diabetes, hypertension | – | Diabetes, hypertension |
| CSF level of proteins (mg/dL) | 25.0 | 109.0 | 59.0 | 52.0 | 22.1 | 29.0 | 26.7 |
| CSF level of glucose (mg/dL) | 47.0 | 3.0 | 59.0 | 44.0 | 102.0 | 61.0 | 46.0 |
| Clinical form | CM | CM | CM | CM | CM | CM | CM |
| Treatment | AmB + FLU | AmB + FLU | LAmB-L+ FLU | AmB + FLU | AmB + FLU | AmB + FLU | AmB + FLU |
| Time of hospitalization in the ICU (days) | 4 | 5 | – | 26 | – | – | 5 |
| Sequelae* | Ocular choroiditis (R) | Loss of vision (R, L) | Decrease of visual and hearing acuity | Facial palsy (R), dysarthria, motor dysfunction | Decrease of visual | Loss of vision (R), decrease of vision acuity | – |
| Time of hospitalization (days) | 18 | 20 | 57 | 100 | 13 | 85 | 15 |
| Clinical outcome | Death | Death | Recovered | Recovered | Death | Recovered | Death |
| Microorganism isolated | C. gattii (VGII/ST20) | C. gattii (VGII/ST5) | C. gattii (VGII/ST5) | C. gattii (VGII/20) | C. gattii (VGII/ST20) | C. gattii (VGII/ST20) | C. gattii (VGII/ST560) |
HBP high blood pressure, CM cryptococcal meningitis, ICU intensive care unit, ISM inferior and superior members, AmB amphotericin B, LAmB liposomal amphotericin B, FLU fluconazole; (˗)=not reported; F female, M male, CFS cerebrospinal fluid, R right, L left. *In the present work, sequels were considered pathologies that persisted after the end of hospitalization and antifungal treatment