![]() ![]() Cryptococcal infection can present as asymptomatic pulmonary colonisation or cause severe central nervous system infection or systemic disseminated infection. The number of CM cases in China has also gradually increased over the past 20 years. The literature reports that 15–20% of AIDS-related deaths are caused by CM, and the mortality rate of AIDS combined with CM is reported to be 20–40% in different regions and even up to 70% per year in resource-limited areas. Recently, the World Health Organization (WHO) issued the first fungal priority pathogen list for invasive fungal diseases, classifying Cryptococcus neoformans as a serious priority pathogen. In AIDS patients, HIV is prone to violate the blood–brain barrier, which facilitates the spread of Cryptococcus neoformans pathogens to the central nervous system, causing CM. Cryptococcal meningitis (CM) is a deep fungal disease caused by a new type of cryptococcal infection. Cryptococcus neoformans, one of the conditional pathogens causing opportunistic infections in humans, is the leading cause of death in patients with advanced AIDS, with the highest incidence of infection in sub-Saharan Africa. According to ‘Progress in AIDS Epidemiology in China’, by the end of 2020, approximately 1.05 million people were living with HIV in China, with a cumulative death toll of 350,000. In China, AIDS is a serious threat to the health of the population, and the main cause of death is an opportunistic infection. The Joint United Nations Programme on HIV and AIDS reported that by the end of 2020, there were 37.7 million living people with HIV/AIDS worldwide, and about 1.5 million new HIV infections are detected each year. Acquired immune deficiency syndrome is caused by human immunodeficiency virus (HIV) infection and is one of the most serious public health problems worldwide. The first official report on acquired immune deficiency syndrome (AIDS) was published in the Morbidity and Mortality Weekly Report on 5 June 1981 in the United States. Therefore, early identification and timely antifungal therapy before the disease progresses to meningitis are of great value in improving the survival rate of patients. Patients with AIDS diagnosed with Cryptococcus neoformans infection have insidious clinical symptoms in the early stage, and their manifestation is often non-specific, resulting in poor prognosis and high mortality among CM patients compared to patients without CM. Multifactorial logistic regression analysis showed that headache risk factors affecting the patient’s prognosis at 12 weeks. A higher incidence of headache, impaired consciousness, nuchal rigidity, first intracranial pressure > 200 mmH 2O and mortality was observed in the CM patients than in the non-CM patients. The overall morbidity and mortality rate after systemic antifungal therapy was higher in the CM patients than in the non-CM patients. The positive rate of cryptococcal capsular antigen, India ink staining and culture in the cerebrospinal fluid examination was higher in the CM patients than in the non-CM patients. Headache and fever were the most common clinical characteristics for patients with CM, while respiratory symptoms and fever were the most common clinical characteristics for patients without CM. Statistical methods were used to analyse the difference in prognosis between the two groups. The differences between the two groups of patients’ clinical symptoms, imaging examinations and laboratory examinations were observed. They were divided into Group A (32 patients with CM) and Group B (28 patients without CM) according to their diagnosis. Our study enrolled AIDS patients diagnosed with Cryptococcus neoformans infection who were hospitalised in our hospital. Herein, we investigate the clinical characteristics and prognostic factors of AIDS patients with Cryptococcus neoformans in Wenzhou, Zhejiang Province, China. Cryptococcal meningitis (CM) threatens people’s health and is the main cause of opportunistic fungus-related death in acquired immune deficiency syndrome (AIDS) patients. ![]()
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