Med Mycol. 2020;58(2):207-210.
Prevalence of cryptococcal antigenemia in hospitalized patients with liver cirrhosis.
제1저자 서현정 · 교신저자 김남중
소속 (1)
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Hospital.
Abstract
The benefits of screening for cryptococcal antigenemia and of preemptive antifungal treatment in HIV-infected patients have been proven. Liver cirrhosis is an important risk factor for cryptococcal infections. Cryptococcal infections are rapidly fatal in patients with liver cirrhosis, especially when diagnosis is delayed. However, screening for cryptococcal antigenemia has not been investigated in these patients. The aim of this study was to investigate the prevalence of cryptococcal antigenemia in hospitalized patients with liver cirrhosis. This prospective study was conducted at Seoul National University Hospital from July 2017 to January 2018. We included patients with liver cirrhosis who were admitted regardless of symptoms or signs suggesting cryptococcal infections. The severity of cirrhosis was evaluated from Child-Pugh and model for end-stage liver disease (MELD) scores. Serum cryptococcal antigenemia was determined using a latex agglutination test. A total of 294 patients were included in the analysis, comprising 104 (35.4%), 100 (34.0%), and 90 (30.6%) patients in Child-Pugh classes A, B, and C, respectively. There were 21 cases of spontaneous bacterial peritonitis, and 14 of hepatic encephalopathy, but none of cryptococcal peritonitis or meningitis. In addition, none of the patient specimens tested positive in the serum cryptococcal latex agglutination test (one-sided 97.5% confidence interval, 0% ∼ 1.2%). Liver cirrhosis is a major risk factor for cryptococcal infections, but the prevalence of serum cryptococcal antigen positivity in patients with liver cirrhosis is very low. Therefore, screening for cryptococcal antigenemia and preemptive antifungal treatment in cirrhotic patients might not be beneficial.
© The Author(s) 2019. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology.
Keywords
Cryptococcus neoformanslatex agglutination testliver cirrhosis
그 밖의 정보
- 출판 형태
- Journal Article
- 저널
- Medical mycology · eISSN 1460-2709
- MeSH
- Aged · Antigens, Fungal / blood / immunology · Cryptococcosis / blood / complications / immunology · Cryptococcus · Female · Hospitalization / statistics & numerical data · Humans · Latex Fixation Tests · Liver Cirrhosis / complications / epidemiology / microbiology · Male · Middle Aged · Prevalence · Prospective Studies · Risk Factors · Serum / immunology · Severity of Illness Index
- Substances
- Antigens, Fungal