Cryptococcosis - The Impact of Delay to Diagnosis.
Clin Microbiol Infect. 2016 May 9;
Authors: Aye C, Henderson A, Yu H, Norton R
Abstract
Cryptococcosis is a mycotic disease caused by the yeast, Cryptococcus sp. It is associated with significant mortality and morbidity including long term neurological sequelae. It is not known whether the high morbidity observed is related to a delay in diagnosis. A retrospective chart review of all cryptococcal infections that had been diagnosed in the region between 1997 and 2015 was performed. Twenty nine cases were identified. Overall mortality rate was 10.3%, with an attributable mortality rate of 6.9%. Forty five percent of patients with central nervous system involvement developed long term neurological deficits. Significant associations were noted between those with and without long term neurological deficits and in both time from onset of symptoms to diagnosis (median of 45.5 days vs 18.5 days respectively) and time from presentation to diagnosis (median 14.5 days vs 7 days respectively). In addition, raised intracranial pressure (ICP) (p = 0.03) and female gender (p = 0.02) were significantly associated with poor neurological outcomes. This highlights the importance of early diagnosis and the need to limit raised ICP to minimize long term neurological deficits.
PMID: 27172806 [PubMed - as supplied by publisher]