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Differences in Immunologic Factors Among Patients Presenting with Altered Mental Status During Cryptococcal Meningitis.
Lofgren, Sarah; Hullsiek, Kathy H; Morawski, Bozena M; Nabeta, Henry W; Kiggundu, Reuben; Taseera, Kabanda; Musubire, Abdu; Schutz, Charlotte; Abassi, Mahsa; Bahr, Nathan C; Tugume, Lillian; Muzoora, Conrad; Williams, Darlisha A; Rolfes, Melissa A; Velamakanni, Sruti S; Rajasingham, Radha; Meintjes, Graeme; Rhein, Joshua; Meya, David B; Boulware, David R.
Afiliação
  • Lofgren S; University of Minnesota, Minneapolis, MN, USA.
  • Hullsiek KH; Infectious Disease Institute, Makerere University, Kampala, Uganda.
  • Morawski BM; University of Minnesota, Minneapolis, MN, USA.
  • Nabeta HW; University of Minnesota, Minneapolis, MN, USA.
  • Kiggundu R; Infectious Disease Institute, Makerere University, Kampala, Uganda.
  • Taseera K; Infectious Disease Institute, Makerere University, Kampala, Uganda.
  • Musubire A; Mbarara University of Science and Technology, Mbarara, Uganda.
  • Schutz C; Infectious Disease Institute, Makerere University, Kampala, Uganda.
  • Abassi M; University of Cape Town, Cape Town, South Africa.
  • Bahr NC; University of Minnesota, Minneapolis, MN, USA.
  • Tugume L; Infectious Disease Institute, Makerere University, Kampala, Uganda.
  • Muzoora C; University of Minnesota, Minneapolis, MN, USA.
  • Williams DA; University of Kansas, Kansas City, KS, USA.
  • Rolfes MA; Infectious Disease Institute, Makerere University, Kampala, Uganda.
  • Velamakanni SS; Mbarara University of Science and Technology, Mbarara, Uganda.
  • Rajasingham R; University of Minnesota, Minneapolis, MN, USA.
  • Meintjes G; Infectious Disease Institute, Makerere University, Kampala, Uganda.
  • Rhein J; University of Minnesota, Minneapolis, MN, USA.
  • Meya DB; University of Minnesota, Minneapolis, MN, USA.
  • Boulware DR; University of Minnesota, Minneapolis, MN, USA.
J Infect Dis ; 215(5): 693-697, 2017 03 01.
Article em En | MEDLINE | ID: mdl-28329080
ABSTRACT
Altered mental status in cryptococcal meningitis results in poorer survival, but underlying causes of altered mentation are poorly understood. Within two clinical trials, we assessed risk factors for altered mental status (GCS score<15) considering baseline clinical characteristics, CSF cytokines/chemokines, and antiretroviral therapy. Among 326 enrolled participants, 97 (30%) had GCS<15 and these patients had lower median CSF cryptococcal antigen titers (P = .042) and CCL2 (P = .005) but higher opening pressures (320 vs. 269 mm H2O; P = .016), IL-10 (P = .044), and CCL3 (P = .008) compared with persons with GCS=15. Altered mental status may be associated with host immune response rather than Cryptococcus burden.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Meningite Criptocócica / Interleucina-10 / Quimiocina CCL3 / Transtornos Mentais Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male Idioma: En Revista: J Infect Dis Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Estados Unidos
Texto completo
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Meningite Criptocócica / Interleucina-10 / Quimiocina CCL3 / Transtornos Mentais Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male Idioma: En Revista: J Infect Dis Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Estados Unidos