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Predictors and long-term outcome of seizures in human immuno-deficiency virus (HIV)-negative cryptococcal meningitis

BACKGROUND: Seizures are one of the most important neurologic complications of human immuno-deficiency virus (HIV)-negative cryptococcal meningitis. A better understanding of the risk associated factors can help predict those who will require treatment. METHODS: This 22-year retrospective study enro...

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Detalles Bibliográficos
Autores principales: Hung, Chih-Wei, Chang, Wen-Neng, Kung, Chia-Te, Tsai, Nai-Wen, Wang, Hung-Chen, Lin, Wei-Che, Huang, Chi-Ren, Huang, Chih-Cheng, Tsai, Wan-Chen, Chang, Hsueh-Wen, Su, Yu-Jih, Lin, Yu-Jun, Cheng, Ben-Chung, Chang, Ya-Ting, Su, Chih-Min, Lu, Cheng-Hsien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4203868/
https://www.ncbi.nlm.nih.gov/pubmed/25307800
http://dx.doi.org/10.1186/s12883-014-0208-x
Descripción
Sumario:BACKGROUND: Seizures are one of the most important neurologic complications of human immuno-deficiency virus (HIV)-negative cryptococcal meningitis. A better understanding of the risk associated factors can help predict those who will require treatment. METHODS: This 22-year retrospective study enrolled 180 patients. Prognostic variables independently associated with seizures or fatality were analyzed using stepwise logistic regression. RESULTS: Twenty-eight patients with HIV-negative cryptococcal meningitis had seizures, including 13 with early seizures and 15 with late seizures. The mean time interval from HIV-negative cryptococcal meningitis to first seizure in the early and late seizure groups were 1.5 and 51.4 days, respectively. Nine out of the 28 cases (32%) occurred within 24 hours of presentation. The overall mortality rate was 54% (15/28) and two patients progressed to epilepsy. CONCLUSIONS: Patients with seizure have worse outcomes and longer hospitalization. Most first seizures occur within one year after the diagnosis of HIV-negative cryptococcal meningitis.