Predictors of postinfectious inflammatory response syndrome in HIV-negative immunocompetent cryptococcal meningitis

Introduction

Cryptococcal meningitis (CM) is an important opportunistic infection worldwide. After initiation of highly active antiretroviral therapy (HAART), about 10%–20% of patients with HIV–CM developed paradoxical cryptococcal immune reconstitution inflammatory syndrome (IRIS).1 2 Many retrospective studies have described risk factors for the development of HIV-related cryptococcal IRIS. A similar exuberant inflammatory response called postinfectious inflammatory response syndrome (PIIRS)1 3 is rarely noticed in previously healthy individuals. Early identification and treatment of PIIRS in patients with CM are very important. However, it is not clear which factors could predict the occurrence of CM-PIIRS. Therefore, in this study, we aimed to fill this research gap and to explore predictive indicators related to HIV-negative immunocompetent CM-PIIRS.

Methods

There were 113 previously healthy patients who were evaluated and treated for CM enrolled between January 2011 and December 2019 at the Third Affiliated Hospital of Sun Yat-sen University,…

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