Clinical features of cryptococcosis in patients with different immune statuses: a multicenter study in Jiangsu Province–China

• DOI: 10.1186/s12879-021-06752-x
• Publication Date: 2021-10-10T06:35:57Z
• Authors: Yu Wang; Yu Gu; Kunlu Shen; Xuefan Cui; Rui Min; Siqing Sun; Chunlai Feng; Yanbin Chen; Li Wang; Min Cao; Jian Yang; Jian Yao; Jing Xu; Dang Lin; Yujian Tao; Guoer Ma; Jiaxin Shi; Bilin Chen; Yueyan Ni; Huanhuan Zhong; Yi Shi; Xin Su
• Keywords: Immunosuppression; Medical microbiology

Abstract Background Current guidelines support different management of cryptococcosis between severely immunodeficient and immunocompetent populations. However, few studies have focused on patients with mild-to-moderate immunodeficiency. We performed this study to determine the clinical features pulmonary (PC) extrapulmonary (EPC) compared them among populations immune statuses appropriate public health threat. Methods All cases were reported by 14 tertiary teaching hospitals in Jiangsu Province, China from January 2013 December 2018. The trends incidence, demographic data, medical history, symptoms, laboratory test indicators, imaging characteristics diagnostic method these then stratified status, namely (IC, no recognized underlying disease or those an that does not influence immunity, such as hypertension), immunodeficiency (MID, diabetes mellitus, end-stage liver kidney disease, autoimmune diseases treated low-dose glucocorticoid therapy, cancer chemotherapy) severe (SID, acquired syndrome, haematologic malignancies, solid organ transplantation stem cell transplantation, idiopathic CD4 lymphocytosis, agranulocytosis, aggressive immunosuppressive therapy other conditions treatments result immunosuppression). Results data 255 collected. In total, 66.3% (169) IC, 16.9% (43) had MID, SID. 10.1% (17) IC EPC, 18.6% (8) MID 74.4% (32) EPC (IC/MID vs. SID, p < 0.001). Fever was more common SID group than groups (69.8% 14.8% 37.2%, Of chest CT scan, most lesions distributed under pleura (72.7%), presenting nodules/lumps (90.3%) consolidations (10.7%). Pleural effusion (33.3% 2.4%, Positivity rate serum capsular polysaccharide antigen detection (CrAg) higher two [100.0% 84.4% (MID) 78.2% (IC), = 0.013]. CrAg also cryptococcal meningitis PC (100.0% 79.5%, 0.015). Conclusions presentation is intermediate similar patients. sensitive for identification