Clinical Characteristics And Prognostic Factors Of Non-AIDS Related Cryptococcus Meningitis

Objective:To investigate the clinical features and related factors that influenceprognosis in patients with non-AIDS related cryptococcal meningitis.Methods:The clinical data of patients with non-AIDS related cryptococcal meningitis diagnosed in the First Affiliated Hospital of Kunming Medical University betweenJanuary 2007 and December 2016 were retrospectively analyzed.The clinical features of the cases included in this study were analyzed and the effects were analyzed.Thepatient's prognosis related factors.Results:Thirty-one cases were included in this study.The ratio of male to female was 2:1.The age of onset was mainly young and middle-aged(83.87%),and the prevalence was mainly farmers(45.16%).The majority of patients with subacute onset of clinical symptoms of headache(96.77%),nausea and vomiting(74.19%),fever(51.61%)mainly.The positive rate of ink staining was low(16.13%without centrifugation,54.84%with centrifugation),and the positive rate of ink staining after centrifugation was significantly increased(p = 0.0014).The positive rate of effective group kernig sign(20.8%)was less than that of ineffective group(71.4%).Logistic analysis showed that the positive sign of kernig was independently associated with the prognosis of patients(p = 0.02),and positive kernig sign was a risk factor for treatment failure(OR = 0.11).Cryptococcus is sensitive to flucytosine,fluconazole,miconazole and ketoconazole.Most of them are sensitive to amphotericin B and voriconazole,and very few are sensitive to itraconazole.The use of fluorocytosine was superior to that of patients without flucytosine(p=0.004).The incidence of adverse reactions was lower than that of non-use(p=0.012).Conclusion:Non-AIDS-related cryptococcal meningitis occurs predominantly in young and middle-aged people,males,and peasants are the main occupations for occupations.The acute onset of polyuria occurs.Clinical symptoms include headache,fever,and nausea and vomiting.Positive Kernig syndrome is an independent risk factor for non-AIDS-related cryptococcal meningitis.Patients with a positive kernig sign have a worse prognosis than patients with a negative kernig sign.Patients with a positive Kernig sign should be better managed.The combination of flucytosine treatment during the induction period can improve the efficacy,but it also increases the incidence of adverse reactions.