ReviewMedicine2016
Cryptococcal meningitis complicating sarcoidosis.
Review in Medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Article
- The emerging links between immunosenescence in innate immune system and neurocryptococcosis.Frontiers in immunology · 2024Review
- Cryptococcal Meningitis Developing in a Patient with Neurosarcoidosis.Internal medicine (Tokyo, Japan) · 2023Article
- Challenging Mimickers in the Diagnosis of Sarcoidosis: A Case Study.Diagnostics (Basel, Switzerland) · 2021Article
- Disseminated Cryptococcal Disease in A Patient With Chronic Chylothorax and a Pleurovenous Catheter, a Case Report With Autopsy Findings.Open forum infectious diseases · 2021Article
- A Rare Presentation of Cryptococcal Meningitis in a Treatment-Naive Patient with Sarcoidosis.European journal of case reports in internal medicine · 2021Article
- Cryptococcosis as a complication of therapy for sarcoidosis: A case report.SAGE open medical case reports · 2021Article
- First report of concomitant cryptococcal meningitis and anti-NMDAR encephalitis.Brain, behavior, & immunity - health · 2020Article
- Fatal fulminant cryptococcemia complicating sarcoidosis: Is it to be expected?Medical mycology case reports · 2018Article
- Cryptococcal Meningitis in a HIV-Negative Patient.European journal of case reports in internal medicine · 2018Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundCryptococcal meningitis is an uncommon but severe complication of sarcoidosis.
methodsWe present 2 patients with cryptococcal meningitis complicating sarcoidosis and compared findings with 38 cases reported in the literature.
resultsWhen analyzing our patients and 38 cases reported in the literature, we found that median age of sarcoidosis patients with cryptococcal meningitis was 39 years (range 30-48); 27 of 33 reported cases (82%) had a history of sarcoidosis. Only 16 of 40 patients (40%) received immunomodulating therapy at the time of diagnosis of cryptococcal meningitis. The diagnosis of cryptococcal meningitis was delayed in 17 of 40 patients (43%), mainly because of the initial suspicion of neurosarcoidosis. Cerebrospinal fluid (CSF) examination showed mildly elevated white blood cell count (range 23-129/mm). Twenty-nine of 32 cases (91%) had a positive CSF culture for Cryptococcus neoformans and 25 of 27 cases (93%) had a positive CSF C neoformans antigen test. CD4 counts were low in all patients in whom counts were performed (84-228/mL). Twelve patients had an unfavorable outcome (32%), of which 7 died (19%) and 24 patients (65%) had a favorable outcome. The rate of unfavorable outcome in patients with a delayed diagnosis was 7 of 17 (41%) compared to 5 of 28 (21%) in patients in whom diagnosis was not delayed.
conclusionCryptococcal meningitis is a rare but life-threatening complication of sarcoidosis. Patients were often initially misdiagnosed as neurosarcoidosis, which resulted in considerable treatment delay and worse outcome. CSF cryptococcal antigen tests are advised in patients with sarcoidosis and meningitis.
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