Format

Send to

Choose Destination
J Infect Dis. 2017 Mar 1;215(5):693-697. doi: 10.1093/infdis/jix033.

Differences in Immunologic Factors Among Patients Presenting with Altered Mental Status During Cryptococcal Meningitis.

Author information

1
University of Minnesota, Minneapolis, MN, USA.
2
Infectious Disease Institute, Makerere University, Kampala, Uganda.
3
Mbarara University of Science and Technology, Mbarara, Uganda.
4
University of Cape Town, Cape Town, South Africa.
5
University of Kansas, Kansas City, KS, USA.

Abstract

Altered mental status in cryptococcal meningitis results in poorer survival, but underlying causes of altered mentation are poorly understood. Within two clinical trials, we assessed risk factors for altered mental status (GCS score<15) considering baseline clinical characteristics, CSF cytokines/chemokines, and antiretroviral therapy. Among 326 enrolled participants, 97 (30%) had GCS<15 and these patients had lower median CSF cryptococcal antigen titers (P = .042) and CCL2 (P = .005) but higher opening pressures (320 vs. 269 mm H2O; P = .016), IL-10 (P = .044), and CCL3 (P = .008) compared with persons with GCS=15. Altered mental status may be associated with host immune response rather than Cryptococcus burden.

KEYWORDS:

Cryptococcal meningitis; HIV; altered mental status; cytokines.; immunology

PMID:
28329080
PMCID:
PMC5388270
DOI:
10.1093/infdis/jix033
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center