• Medicina · Jan 2024

    Observational Study

    [Meningeal cryptococcosis in patients living with HIV. Experience in intensive care].

    • Yésica Lamberto, Pablo Saúl, Rosana Gregori-Sabelli, Milagro Sánchez-Cunto, Viviana Chediack, and Eleonora Cunto.
    • Departamento de Terapia Intensiva-DAIPIC, Hospital de Infecciosas Francisco Javier Muñiz, Buenos Aires, Argentina. E-mail: yesica.lamberto@gmail.com.
    • Medicina (B Aires). 2024 Jan 1; 84 (2): 256260256-260.

    IntroductionMeningeal cryptococcosis (MC) is a frequent cause of meningoencephalitis in people living with HIV (PLHIV), leading to substantial morbidity (20-55%). Clinical characteristics, lethality and adverse prognostic factors in PLHIV with MC admitted to intensive care units (ICUs) are described.MethodsA retrospective observational study. Period from 11/21/2006 to 05/24/2023. It involved 154 adult PLHIV diagnosed with MC and admitted to ICUs. Percentages and absolute values were compared by Chi-Square or Fisher's test and medians by Mann-Whitney test. The association with mortality was assessed by logistic regression. SPSS 23.0 software was used. A p-value <0.05 was considered significant.ResultsPatients who died and those who survived were comparable in age and sex (p>0.05). Univariate analysis showed that impaired functional and nutritional status, lack of previous highly active antiretroviral therapy, CD4 <100 cells, APACHE II ≥ 13 and a PLHIV prognostic score ≥ 8 points, requiring mechanical ventilation (MV), respiratory failure, renal failure, neurological dysfunction or sepsis could be associated (p<0.05) with mortality. Logistic regression established that impaired functional and nutritional status, a PLHIV prognostic score ≥ 8, need for MV and presence of sepsis would be independent variables associated with mortality.ConclusionThe results indicate that altered functional and nutritional status, a PLHIV prognostic score ≥ 8 points, requiring MV and suffering sepsis on admission to the ICU are more frequent in deceased patients, and they could therefore serve as independent variables to predict a higher risk of mortality.

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