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• Clinical Article •
Clinical and imaging characteristics of cryptococcal intracranial infection in patients with acquired immune deficiency syndrome
YIN Yue  LI Hongjun 

Cite this article as: Yin Y, Li HJ. Clinical and imaging characteristics of cryptococcal intracranial infection in patients with acquired immune deficiency syndrome[J]. Chin J Magn Reson Imaging, 2021, 12(3): 24-29. DOI:10.12015/issn.1674-8034.2021.03.006.


[Abstract] Objective To investigate the clinical and imaging characteristics of cryptococcus meningitis (CM) in patients with acquired immunedeficiency syndrome (AIDS), thus to improve the diagnosis of this disease. Materials andMethods The clinical and imaging data of 20 AIDS patients with CM were retrospectively analyzed.Results Among the 20 cases, there were 17 males and 3 females. The age were ranged from 25 to 63 (median age 40.4); the CD4 counts were range from 1 to 162/μL (median number 26/μL). In cerebrospinal fluid, glucose was (2.45±1.090) mmol/L, and chlorine content was (119.86±4.669) mmol/L. Clinical symptoms included headache (80%), nausea and vomiting (15%), disturbance of consciousness (5%), blurred vision (5%) and fever (5%), 10% cases have no symptoms. On MRI, 11 cases were mainly characterized by dilated perivascular spaces (PVS) and pseudocyst, 6 cases were mainly characterized by meningitis/meningoencephalitis, 1 case presented both dilated PVS and meningitis/meningoencephalitis, 1 case presented with meningitis/meningoencephalitis and miliary nodules, 1 case presented other imaging feature.Conclusions The most common clinical symptom of AIDS patients with CM was headache, followed by nausea and vomiting. Imaging features included dilated PVS and pseudocyst.
[Keywords] acquired immunedeficiency syndrome；cryptococcus meningitis；magnetic resonance imaging；clinical feature；imaging feature

YIN Yue   LI Hongjun*  

Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China

Li HJ, Email: lihongjun00113@126.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  National Nature Science Foundation of China No. 61936013
Received  2020-10-14
Accepted  2021-01-21
DOI: 10.12015/issn.1674-8034.2021.03.006
Cite this article as: Yin Y, Li HJ. Clinical and imaging characteristics of cryptococcal intracranial infection in patients with acquired immune deficiency syndrome[J]. Chin J Magn Reson Imaging, 2021, 12(3): 24-29. DOI:10.12015/issn.1674-8034.2021.03.006.

1
Lazera MS, Cavalcanti MA, Londero AT, et al. Possible primary ecological niche of cryptococcus neoformans. Med Mycol, 2000, 38(5): 379-383. DOI: 10.1080/mmy.38.379.383
2
Tugume L, Rhein J, Hullsiek KH, et al. HIV-associated cryptococcal meningitis occurring at relatively higher CD4 counts. J Infect Dis, 2019, 219: 877-883. DOI: 10.1093/infdis/jiy602
3
Skipper C, Abassi M, Boulware DR. Diagnosis and management of central nervous system cryptococcal infections in HIV-infected adults. J Fungi, 2019, 5(3): 65. DOI: 10.3390/jof5030065
4
Wang LL, Li AX, Yang X, et al. Clinical analysis for 67 AIDS patients with cryptococcal meningitis. Chin J Mycol, 2019, 14(6): 342-345.
5
Kambugu A, Meya DB, Rhein J, et al. Outcomes of cryptococcal meningitis in uganda before and after the availability of highly active antiretroviral therapy. Clin Infect Dis, 2008, 46(11): 1694-1701. DOI: 10.1086/587667
6
Eshun-Wilson I, Okwen MP, Richardson M, et al. Early versus delayed antiretroviral treatment in HIV-positive people with cryptococcal meningitis. Cochrane Database Syst Rev, 2018, 24(7): CD009012. DOI: 10.1002/14651858.CD009012.pub3
7
AIDS and Hepatitis C Professional Group, Society of Infectious Diseases, Chinese Medical Association, Chinese Center for Disease Control and Prevention. Chinese guidelines for diagnosis and treatment of HIV/AIDS (2018). Infect Dis Informat, 2018, 31(6): 481-499, 504. DOI: 10.3969/j.issn.1007-8134.2018.06.001
8
Ge XL, Tan SY, Zhang YX, et al. Infectious status and antibacterial agents using of Cryptococcus Neoformans infection. Chin J Exper Clin Infect Dis (Elect), 2018, 12(4): 376-380. DOI: 10.3877/cma.j.issn.1674-1358.2018.04.012
9
Liaw SJ, Wu HC, Hsueh PR. Microbiological characteristics of clinical isolates of Cryptococcus neoformans in Taiwan: serotypes, mating types, molecular types, virulence factors, and antifungal susceptibility. Clin Microbiol Infect, 2010, 16(6): 696-703. DOI: 10.1111/j.1469-0691.2009.02930.x
10
Yang Y, Zeng J, Hua W, et al. Diagnosis and treatment of cryptococcal meningitis in China. Chin J Infect Dis, 2019, 37(11): 692-695. DOI: 10.3760/cma.j.issn.1000-6680.2019.11.015
11
Patel RKK, Leeme T, Azzo C, et al. High mortality in HIV-associated cryptococcal meningitis patients treated with amphotericin B-based therapy under routine care conditions in Africa. Open Forum Infect Dis, 2018, 5(11): ofy267. DOI: 10.1093/ofid/ofy267
12
Li WF, Liu Y, Peng Y. Recreach progress in the pathogenesis and CT, MRI characteristic of cryptococcal meningeal encephalitis in children. Beijing Med J, 2018, 40(7): 687-689. DOI: 10.15932/j.0253-9713.2018.07.023
13
Lee SJ, Choi HK, Son J, et al. Cryptococcal meningitis in patients with or without human immunodeficiency virus:experience in a tertiary hospital. yonsei med j, 2011, 52 (3): 482-487. DOI: 10.3349/ymj.2011.52.3.482
14
Yang SN, Qin W, Yang L, et al. Research progress of enlarged perivascular space in the brain. Chin J Geriatr Heart Brain Vessel Dis, 2020, 22(4): 441-443. DOI: 10.3969/j.issn.1009-0126.2020.04.028
15
Bouvy WH, Biessels GJ, Kuijf HJ, et al. Visualization of perivascular spaces and perforating arteries with 7 T magnetic resonance imaging. Invest Radioi, 2014, 49(5): 307-313. DOI: 10.1097/RLI.0000000000000027
16
Kaufman-Francis K, Djordjevic JT, Juillard PG, et al. The early innate immune response to, and phagocyte-dependent entry of, cryptococcus neoformans map to the perivascular space of cortical post-capillary venules in neurocryptococcosi. Am J Pathol, 2018, 188(7): 1653-1665. DOI: 10.1016/j.ajpath.2018.03.015
17
Ruiz A, Post MJ, Bundschu CC. Dentate nuclei involvement in AIDS patients with CNS cryptococcosis: imaging findings with pathologic correlation. J Comput Assist Tomogr, 1997, 21(2): 175. DOI: 10.1097/00004728-199703000-00003
18
Yuan H, Hu ZL, Xu CJ. Clinical and imaging features of acquired immunodeficiency syndrome associated with cryptococcal meningitis. Elect J Emerg Infect Dis, 2020, 5(1): 56-59.
19
Offiah CE, Naseer A. Spectrum of imaging appearances of intracranial cryptococcal infection in HIV/AIDS patients in the anti-retroviral therapy era. Clin Radiol, 2016, 71(1): 9-17. DOI: 10.1016/j.crad.2015.10.005
20
Zhao D, Wen H, Zhu HM, et al. Advance in mechanism of AQP4 on cerebral edema in cryptococcal meningitis. Chin J Mycol, 2012, 7(4): 252-254. DOI: 10.3969/j.issn.1673-3827.2012.04.016
21
Fan J, Wen H, Zhu YJ, et al. Changes of water content in brain tissue of cryptococcal infected mice.Chinese J Mycol, 2008, 3(4): 201-204. DOI: 10.3969/j.issn.1673-3827.2008.04.003
22
Hao ZF, OuYang XM, Mei KY, et al. Cryptococcal granuloma of the right frontal lobe and related review of the literature. Chin J Contemp Neurol Neurosurg, 2010, 10(4): 488-492. DOI: 10.11816/cn.ni.2019-182502
23
Wang L, Wang XL, Zhu B, et al. Magnetic resonanc eimaging features of patients with cryptococcal infection. Chin J Nosocomiol, 2019, 29(16): 2459-2462. DOI: 10.11816/cn.ni.2019-182502
24
Zhao CH, Tian PC, Zhang B, et al. Ventriculoperitoneal shunt for cryptococcal meningitis in children with hydrocephalus. Chin J Nerv Ment Dis, 2018, 44(11): 678-681. DOI: 10.3969/j.issn.1002-0152.2018.11.008
25
Tuberculosis Branch of Chinese Medical Association, Credit expert consensus writing group for intracranial tuberculosis imaging. Expert consensus on imaging typing of intracranial tuberculosis. Chin J Tubercul Respiratory Dis, 2015, 38 (11): 805-809. DOI: 10.3760/cma.j.issn.1001-0939.2015.11.003
26
Srichatrapimuk S, Sungkanuparph S. Integrated therapy for HIV and cryptococcosis. AIDS Res Ther, 2016, 13(1): 42. DOI: 10.1186/s12981-016-0126-7
27
Williamson PR, Jaiwis JN, Panackal AA, et al. Cryptococcal meningitis: epidemiology, immunology, diagnosis and therapy. Nat Rev Neurol, 2017, 13(1): 13-24. DOI: 10.1038/nrneurol.2016.167
28
Wu YS, Liu M, Lu YQ, et al. Differential clinical features of cryptococcal meningitis versus tuberculous meningitis in AIDS patients. Chin J Infect Chemotherapy, 2019, 19(6): 590-593. DOI: 10.16718/j.1009-7708.2019.06.002
29
Cheng Y, Huang T, Chen HD, et al. Diagnosis and differential diagnosis of cryptococcus neoformans meningitis and tuberculous meningitis. Chin J Antitubercul, 2019, 19(41): 48-52. DOI: 10.3969/j.issn.1000-6621.2019.01.011
30
Xiao HQ, Wang XY, Xie FF, et al. The differential diagnosis of MRI features on tuberculous meningitisand cryptococcal neoformans meningitis. J Traditional Chin Med University Hunan, 2015, 35(5): 53-54. DOI: 10.3969/j.issn.1674-070X.2015.05.018
31
Augusto L, Neves N, Reis C, et al. Clinical and radiological characterization of progressive multifocal leukoencephalopathy in HIV-infected patients: a retrospective analysis and review of the literature. Acta Med Port, 2015, 28(3): 286-296. DOI: 10.20344/amp.5950
32
Liu YL, Wen LJ, Wang DQ. Clinical and MRI characteristics analysis of progressive multifocal eukoencephalopathy in AIDS patients. Chin J CT MRI, 2019, 17(7): 12-15. DOI: 10.3969/j.issn.1672-5131.2019.07.004

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