ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020
A Multicenter, Longitudinal Cohort Study of Cryptococcosis in Human Immunodeficiency Virus-negative People in the United States.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 1 of them a synthesis that pooled it.
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Who cites it
66 citing papers in PubMed, 1 synthesis or guideline pooled it, 100 citations in OpenAlex.
- Global guideline for the diagnosis and management of cryptococcosis: an initiative of the ECMM and ISHAM in cooperation with the ASM.The Lancet. Infectious diseases · 2024Guideline
- Clinical Phenotypes, Immunosuppressive Exposures, and Outcomes in Pulmonary vs Extrapulmonary Cryptococcosis Among Non-HIV, Non-Transplant Adults: A U.S. Claims Analysis.Open forum infectious diseases · 2026Article
- Characteristics of Mortality in HIV-negative Cryptococcosis Patients: Analysis of a Cohort of 743 Patients.Open forum infectious diseases · 2026Article
- Epidemiology and Clinical Features of Cryptococcosis Among Individuals Without HIV Infection: An Observational International Multicenter Study (MSG-11).Open forum infectious diseases · 2026Article
- Corticosteroid Therapy and Long-Term Outcomes of Post-Infectious Inflammatory Syndrome in Non-HIV Immunosuppressed Cryptococcal Meningitis: A Multicenter Case Series.The Journal of infectious diseases · 2026Article
- Cryptococcosis in Colombia: Analysis of Data from Laboratory-Based Surveillance 2017-2024.Journal of fungi (Basel, Switzerland) · 2026Article
- Disseminated Cryptococcosis in a Non-HIV Patient: Diagnostic Value of Integrating mNGS, Culture, and Antigen Testing.Infection and drug resistance · 2026Article
- Cryptococcal Meningitis Treatment Beyond HIV: Recognizing the Need for Individualized Immune-Based Strategies.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- The Pain Is in the Brain With the Sugar-Coated Killer.The Journal of infectious diseases · 2025Review
- Effectiveness of voriconazole therapy for pulmonary cryptococcosis in fluconazole treatment failure: a multicenter real-world study.BMC infectious diseases · 2025Article
- Target product profile and discovery and development path for novel cryptococcal disease treatments.The Journal of infection · 2025Review
- Peripheral blood CD4The Journal of infection · 2025Article
- Clinical Features of Invasive Fungal Disease in China Tertiary Hospital: A Prospective, Multicenter Study.Mycopathologia · 2025Article
- Invasive fungal infections in patients with liver disease: immunological and clinical considerations for the intensive care unit.Intensive care medicine · 2025Review
- Antigen Titers in Cryptococcal Meningitis: What Determines How Fast They Fall?The Journal of infectious diseases · 2024Article
- Article
- A Single-center Experience of Coccidioides Meningitis in Immunocompetent Patients: Case Series and Literature Review.Open forum infectious diseases · 2024Article
- Clinical characteristics and prognostic factors of pulmonary and extrapulmonary cryptococcosis.BMC infectious diseases · 2024Article
- The relationship between lung CT features and serum cryptococcal antigen titers in localized pulmonary cryptococcosis patients.BMC pulmonary medicine · 2024Article
- Cryptococcosis Associated With Biologic Therapy: A Narrative Review.Open forum infectious diseases · 2024Review
6 more citing papers are in PubMed but not listed here.
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Authors and funding
12 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundCryptococcosis is increasingly recognized in people without human immunodeficiency virus (HIV).
methodsA multicenter, prospective cohort study was performed in 25 US centers. Consenting patients were prospectively followed for ≤2 years. Neurological morbidities were assessed with longitudinal event depiction and functional scores (Montreal Cognitive Assessment [MoCA]). Risks of death were analyzed using Cox regression.
resultsOne hundred forty-five subjects were enrolled. Most were male (95; 65.5%) and had immunosuppression (120; 82.8%), including solid organ transplant (SOT; 33.8%), autoimmunity (15.9%), and hematologic malignancies (11.7%). Disease involved the central nervous system (CNS) in 71 subjects (49%). Fever was uncommon, documented in 40 (27.8%) subjects, and absence was associated with diagnostic delay (mean: 48.2 vs 16.5 days; P = .007). Abnormal MoCA scores (<26) were predictive of CNS disease; low scores (<22) were associated with poor long-term cognition. Longitudinal event depiction demonstrated frequent complications in people with CNS disease; 25 subjects (35.2%) required >1 lumbar puncture and 8 (11.3%) required ventriculostomies. In multivariable models, older age (>60 years) was associated with higher risks of death (hazard ratio [HR], 2.14; 95% confidence interval [CI], 1.05-4.38; P = .036), and lower risks were noted with underlying hematologic malignancy (HR, 0.29; 95% CI, 0.09-0.98; P = .05) and prior SOT (HR, 0.153; 95% CI, 0.05-0.44; P = .001).
conclusionsDespite aggressive antifungal therapies, outcomes of CNS cryptococcosis in people without HIV are characterized by substantial long-term neurological sequelae. Studies are needed to understand mechanism(s) of cognitive decline and to enable better treatment algorithms.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.