ArticleFrontiers in neurology
High mortality and amphotericin B-related nephrotoxicity in cerebral cryptococcosis in a low-resource neurology referral center: a prospective cohort study.
Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Cerebral cryptococcosis (neurocryptococcosis) is an important cause of meningoencephalitis among immunocompromised people worldwide, particularly in regions with limited access to antiretroviral therapy and to optimal antifungal agents. Methods: Prospective observational cohort study of consecutive adults hospitalized with cerebral cryptococcosis at the Neurology Service of the Servicio Autónomo Hospital Universitario de Maracaibo, Maracaibo, Zulia, Venezuela (January 2022 to July 2024). Data were collected using a validated instrument; modified Rankin Scale (mRS) assessed disability at discharge. Results: Sixty-two patients (mean age 36.5 ± 12.9 years; 66.1% male) were included; 72.6% were HIV-positive. All patients presented headache, neck stiffness and altered mental status. Mean CSF protein was 103.5 mg/dL, cell count 504.5 cells/mm Conclusion: Cerebral cryptococcosis in this referral setting affects predominantly young, HIV-infected adults and is associated with high mortality and disability. Amphotericin B-related nephrotoxicity and hypokalemia were common and associated with worse outcomes, underscoring the need for nephroprotection protocols and optimized antifungal strategies in resource-limited settings.
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