Clinical Characteristics of Patients with Cryptococcal Meningitis in Hokkaido: A Case Series

Intern Med. 2024 May 1;63(9):1281-1287. doi: 10.2169/internalmedicine.1944-23. Epub 2023 Sep 15.

Abstract

We retrospectively reviewed the medical histories, examination results, treatments, and prognoses of nine patients with cryptococcal meningitis who were diagnosed and treated at Hokkaido University Hospital and its affiliated hospitals over the past 10 years. Cryptococcal meningitis can develop even in immunocompetent hosts, and its prognosis is poor owing to diagnostic difficulties and delayed treatment. Although liposomal amphotericin B and oral 5-fluorocytosine are standard therapies, voriconazole or intraventricular administration of amphotericin B may also be considered treatment options for refractory patients. Some patients develop delayed exacerbations owing to immunological mechanisms that require steroid therapy.

Keywords: HIV-negative; Hokkaido; Japan; case series; cryptococcal meningitis; cryptococcus.

MeSH terms

  • Adult
  • Aged
  • Amphotericin B / therapeutic use
  • Antifungal Agents* / therapeutic use
  • Female
  • Humans
  • Japan / epidemiology
  • Male
  • Meningitis, Cryptococcal* / complications
  • Meningitis, Cryptococcal* / diagnosis
  • Meningitis, Cryptococcal* / drug therapy
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Voriconazole / therapeutic use

Substances

  • Amphotericin B
  • Antifungal Agents
  • Voriconazole