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- W4256159797 abstract "Abstract Background Raised intracranial pressure (ICP) and insufficient antifungal regimens, are the two main factors result to unsatisfactory outcomes in non-HIV cryptococcal meningitis (CM) patients. In this study, we try to discuss that whether triple therapy of amphotericin B (AmB), fluconazole (Flu), 5-flucytosine (5-FC) plus ventriculoperitoneal shunts (VPS) is superior to AmB, 5-FC, Flu plus intermittent lumbar puncture in induction therapy in non-HIV CM patients with increased ICP. Methods We reviewed 66 clinical records from non-HIV CM patients with increased ICP. The demographic and clinical characteristics, BMRC staging, cerebrospinal fluid profiles (CSF), brain magnetic resonance imaging, treatment, and outcomes of these individuals were retrospectively analyzed. All non-HIV CM patients with increased ICP (≥ 25 cmH2O) were divided into two groups, including 27 patients treated with triple antifungal agents and 39 patients treated with the same triple therapy plus VPS. Results Triple therapy plus VPS group had a significantly higher frequency of satisfactory outcomes. More patients in triple therapy plus VPS group have CSF sterilization at 10 weeks follow-up. And patients in triple therapy plus VPS group present with lower CSF opening pressure, less CSF cryptococci count and CSF culture positive, and lower BMRC staging scores one week after VPS. Patients in triple therapy plus VPS group got the improvement in neurological function circumstances evaluated by comparing the BMRC staging before and after VPS. Triple therapy plus VPS group patients had shorter hospital stay. Conclusions Triple antifungal agents combined with VPS can effectively reduce ICP, have faster rate of clearance of Cryptococcus, improve nerve function, shorten hospitalization time and get better outcomes in non-HIV CM patients with increased ICP. Our study indicated that triple therapy plus early VPS is maybe the optimal treatment for non-HIV CM patients with increased ICP." @default.
- W4256159797 created "2022-05-12" @default.
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- W4256159797 date "2020-05-08" @default.
- W4256159797 modified "2023-09-24" @default.
- W4256159797 title "Triple therapy combined with ventriculoperitoneal shunts can improve neurological function and shorten hospitalization time in non-HIV cryptococcal meningitis patients with increased intracranial pressure" @default.
- W4256159797 doi "https://doi.org/10.21203/rs.3.rs-26178/v1" @default.
- W4256159797 hasPublicationYear "2020" @default.
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