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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
5
pubmed:dateCreated
1999-2-10
pubmed:abstractText
The incidence of acute respiratory failure (ARF) associated with cryptococcal disease in patients with AIDS is underestimated in the literature. We performed a retrospective, case-control (referent) study to determine the prevalence of ARF associated with cryptococcal disease and analyzed associated factors. Potential cases of ARF were identified at four university-affiliated teaching hospitals from a cohort of 210 patients with AIDS who had positive cryptococcal antigen tests and/or Cryptococcus neoformans isolated from any body site. Twenty-nine of the 210 (13.8%) had ARF associated with cryptococcal disease. Nineteen were thought to have respiratory failure due solely to C. neoformans. The demographic, clinical, laboratory, treatment, and outcome data of 19 cases of respiratory failure were compared with data for 20 patients without respiratory failure. In-hospital mortality was 100% and median survival was 2 days for cases, vs. 25% and > 365 days, respectively, for referents. The clinical presentation was identical to that of Pneumocystis carinii pneumonia. In multivariate analysis, variables independently predictive of ARF in patients with cryptococcal disease were black race, a lactate dehydrogenase level of > or = 500 IU/L, the presence of interstitial infiltrates, and the presence of cutaneous lesions. ARF with cryptococcosis in patients with AIDS is associated with disseminated disease and high mortality. The diagnosis frequently is not considered before death. Serum cryptococcal antigen testing is a sensitive and rapid screening method.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Nov
pubmed:issn
1058-4838
pubmed:author
pubmed:issnType
Print
pubmed:volume
27
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1231-7
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed-meshheading:9827275-AIDS-Related Opportunistic Infections, pubmed-meshheading:9827275-Acute Disease, pubmed-meshheading:9827275-Adult, pubmed-meshheading:9827275-Case-Control Studies, pubmed-meshheading:9827275-Cohort Studies, pubmed-meshheading:9827275-Cryptococcosis, pubmed-meshheading:9827275-Cryptococcus neoformans, pubmed-meshheading:9827275-Female, pubmed-meshheading:9827275-Hospitals, Teaching, pubmed-meshheading:9827275-Hospitals, University, pubmed-meshheading:9827275-Humans, pubmed-meshheading:9827275-Incidence, pubmed-meshheading:9827275-Lung Diseases, Fungal, pubmed-meshheading:9827275-Male, pubmed-meshheading:9827275-Middle Aged, pubmed-meshheading:9827275-Respiratory Insufficiency, pubmed-meshheading:9827275-Retrospective Studies, pubmed-meshheading:9827275-Risk Factors
pubmed:year
1998
pubmed:articleTitle
Acute respiratory failure associated with cryptococcosis in patients with AIDS: analysis of predictive factors.
pubmed:affiliation
Infectious Disease Sections, Veterans Affairs Medical Center, Houston, Texas 77030-4211, USA.
pubmed:publicationType
Journal Article