The utility of cerebrospinal fluid white cell count during the prognostic assessment for cryptococcal meningitis patients: a retrospective study.
Background: The incidence of cryptococcal meningitis (CM) has gradually increased in recent years. Cerebrospinal fluid (CSF) cytology and cell count are very important for CM on etiology diagnosis and assessment of disease status and therapeutic response. However, the clinical significance of CSF wh...
| Publicado en: | BMC Infectious Diseases Vol. 20; no. 1; pp. 1 - 15 |
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| Autores principales: | , , |
| Formato: | Journal Article |
| Publicado: |
BioMed Central
8/5/2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=144981291&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 144981291 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712334 1CHU jtl: BMC Infectious Diseases issn: 14712334 maglogo: N pubinfo: dt: 8/5/2020 vid: 20 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 144981291 144981291 NLM32758162 10.1186/s12879-020-05287-x NLM32758162 144981291 ppf: 1 ppct: 14 formats: tig: atl: The utility of cerebrospinal fluid white cell count during the prognostic assessment for cryptococcal meningitis patients: a retrospective study. aug: au: Qu, Junyan Jiang, Jingwen Lv, Xiaoju affil: Center of Infectious Disease, West China Hospital, Sichuan University, 37 Guoxue Lane, 610041, Chengdu, China sug: subj: Meningitis, Cryptococcal Cerebrospinal Fluid Meningitis, Cryptococcal Diagnosis Cryptococcus Human Immunodeficiency Virus Female Prospective Studies Treatment Outcomes Meningitis, Cryptococcal Drug Therapy China Prognosis Forecasting HIV Infections Antifungal Agents Therapeutic Use Middle Age HIV Infections Drug Therapy Adult Anti-Retroviral Agents Therapeutic Use Retrospective Design Male Meningitis, Cryptococcal Microbiology Sensitivity and Specificity Scales Middle Aged: 45-64 years Adult: 19-44 years Female Male ab: Background: The incidence of cryptococcal meningitis (CM) has gradually increased in recent years. Cerebrospinal fluid (CSF) cytology and cell count are very important for CM on etiology diagnosis and assessment of disease status and therapeutic response. However, the clinical significance of CSF white cell count (WCC) in CM patients is not fully understood. Using longitudinal data of CSF WCC and its relationship with clinical outcomes in CM patients, we aimed to elucidate the clinical significance of this test.Methods: We retrospectively analyzed the medical records of 150 CM patients admitted to our hospital between January 2008 and December 2018.Results: CM patients with lower baseline CSF WCC, CSF protein concentration or CD4/CD8 ratio, and those with altered mentation or HIV coinfection were more likely to have poor clinical outcome (P<0.05). CM patients with triple therapy during the induction period presented with a better clinical outcome (P<0.05). Baseline CSF WCC had a moderate positive correlation with peripheral CD4+ T lymphocyte count (r = 0.738, P < 0.001) and CD4+ T lymphocyte percentage (r = 0.616, P < 0.001). The best cut-off value to predict a poor clinical outcome was 40 cells/μL during baseline CSF WCC. The predictive model incorporating longitudinal data of CSF WCC had better sensitivity, specificity, and accuracy than a model incorporating only baseline CSF WCC data.Conclusions: Our results indicated that baseline CSF WCC and changes in CSF WCC over time could be used to assess the prognosis of CM patients. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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