Differences in Immunologic Factors Among Patients Presenting with Altered Mental Status During Cryptococcal Meningitis.
rct · Level II
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- Record sourced from PubMed, PMID 28329080.
- Also identified by DOI 10.1093/infdis/jix033 and PMC identifier 5388270.
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Abstract
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.
Medical subject headings
- Chemokine CCL3
- Interleukin-10
- Meningitis, Cryptococcal
- Mental Disorders