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. 2021 Feb 5;8(4):ofab066.
doi: 10.1093/ofid/ofab066. eCollection 2021 Apr.

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

Síle F Molloy  1   2 , Brad Ross  1 , Cecilia Kanyama  3 , Sayoki Mfinanga  4   5 , Sokoine Lesikari  4 , Robert S Heyderman  6   7   8 , Newton Kalata  7   8 , Jayne Ellis  7   8   9 , Charles Kouanfack  10 , Duncan Chanda  11 , Elvis Temfack  12   13 , Shabir Lakhi  14 , Anand Moodley  15 , Adrienne K Chan  16   17 , Joep J van Oosterhout  18   19 , Yacouba Mapoure  12 , Peter Mwaba  20 , David G Lalloo  5 , Duolao Wang  5 , Olivier Lortholary  21   22 , Shabbar Jaffar  5 , Mina C Hosseinipour  3   23 , Angela Loyse  1   2 , Thomas S Harrison  1   2 , Tihana Bicanic  1   2
Affiliations

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

Síle F Molloy et al. Open Forum Infect Dis. .

Abstract

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.

Keywords: HIV; cryptococcal meningitis; fungal burden; raised intracranial pressure; visual loss.

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Figures

Figure 1.
Figure 1.
(a) Box plot (median, interquartile range, range) of baseline cerebrospinal fluid (CSF) opening pressure by visual acuity group at presentation. (b) Box plot of baseline fungal burden by visual acuity group at presentation. CF, count fingers; HM, hand motion; LP, light perception; ML, moderate loss; NN, near normal; NNV, near-normal vision; NV, no vision (blind); PL, perceives light.
See this image and copyright information in PMC

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