Fungal Burden and Raised Intracranial Pressure Are Independently Associated With Visual Loss in Human Immunodeficiency Virus-Associated Cryptococcal Meningitis.

Síle F Molloy ; Brad Ross ; Cecilia Kanyama ; Sayoki Mfinanga ; Sokoine Lesikari ; Robert S Heyderman ORCID logo ; Newton Kalata ; Jayne Ellis ORCID logo ; Charles Kouanfack ; Duncan Chanda ; +15 more... Elvis Temfack ORCID logo ; Shabir Lakhi ; Anand Moodley ; Adrienne K Chan ; Joep J van Oosterhout ; Yacouba Mapoure ; Peter Mwaba ; David G Lalloo ; Duolao Wang ; Olivier Lortholary ; Shabbar Jaffar ; Mina C Hosseinipour ; Angela Loyse ; Thomas S Harrison ; Tihana Bicanic ORCID logo ; (2021) Fungal Burden and Raised Intracranial Pressure Are Independently Associated With Visual Loss in Human Immunodeficiency Virus-Associated Cryptococcal Meningitis. Open forum infectious diseases, 8 (4). ofab066-. ISSN 2328-8957 DOI: 10.1093/ofid/ofab066
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Among 472 patients with human immunodeficiency virus-associated cryptococcal meningitis, 16% had severe visual loss at presentation, and 46% of these were 4-week survivors and remained severely impaired. Baseline cerebrospinal fluid opening pressure ≥40 cmH2O (adjusted odds ratio [aOR], 2.56; 95% confidence interval [CI], 1.36-4.83; P = .02) and fungal burden >6.0 log10 colonies/mL (aOR, 3.01; 95% CI, 1.58-5.7; P = .003) were independently associated with severe visual loss.


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