Differences in Immunologic Factors Among Patients Presenting with Altered Mental Status During Cryptococcal Meningitis | Zendy

Sarah M Lofgren | Zendy; Kathy Huppler Hullsiek | Zendy; Bożena M Morawski | Zendy; Henry W. Nabeta | Zendy; Reuben Kiggundu | Zendy; Kabanda Taseera | Zendy; Abdu Musubire | Zendy; Charlotte Schutz | Zendy; Mahsa Abassi | Zendy; Nathan C. Bahr | Zendy; Lillian Tugume | Zendy; Conrad Muzoora | Zendy; Darlisha A Williams | Zendy; Melissa A. Rolfes | Zendy; SRUTI S VELAMAKANNI | Zendy; Radha Rajasingham | Zendy; Graeme Meintjes | Zendy; Joshua Rhein | Zendy; David B. Meya | Zendy; David R. Boulware | Zendy

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Differences in Immunologic Factors Among Patients Presenting with Altered Mental Status During Cryptococcal Meningitis

Author(s) -

Sarah M Lofgren,

Kathy Huppler Hullsiek,

Bożena M Morawski,

Henry W. Nabeta,

Reuben Kiggundu,

Kabanda Taseera,

Abdu Musubire,

Charlotte Schutz,

Mahsa Abassi,

Nathan C. Bahr,

Lillian Tugume,

Conrad Muzoora,

Darlisha A Williams,

Melissa A. Rolfes,

SRUTI S VELAMAKANNI,

Radha Rajasingham,

Graeme Meintjes,

Joshua Rhein,

David B. Meya,

David R. Boulware

Publication year - 2017

Publication title -

the journal of infectious diseases

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 2.69

H-Index - 252

eISSN - 1537-6613

pISSN - 0022-1899

DOI - 10.1093/infdis/jix033

Subject(s) - medicine , cryptococcal meningitis , immunology , altered mental status , chemokine , meningitis , immune status , cryptococcus , immune system , cryptococcosis , human immunodeficiency virus (hiv) , viral disease , psychiatry , biology , pediatrics , microbiology and biotechnology

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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