Cryptococcal meningitis (CM) is a rare complication in HIV-negative patients with nephrotic syndrome (NS), and knowledge about the clinical profile of NS with CM is limited. We performed a retrospective study of all patients with CM-NS admitted to the Jiangxi Chest Hospital (JCH) between 2011 and 2019 and systematically reviewed cases of CM-NS reported in the Chinese language. Among a total of 226 CM patients referred to the JCH, seven had NS (3.1%); these patients were combined with 22 CM-NS cases reported in the Chinese language for analysis. Headache, fever, nausea, and meningeal irritation were the most common initial symptoms, and the median time from symptom onset to CM diagnostic confirmation was 30 days. One patient initially tested negative for CM but was later confirmed to be positive. Among the 29 analysed patients, 41.4% (12/29) were misdiagnosed with other complications, including four patients from the JCH (4/7, 57.1%) and eight patients from published reports (8/22, 36.3%). The overall mortality rate was 17.2% (5/29); among these patients, 60% (3/5) were misdiagnosed. Induction treatment with amphotericin B plus 5-fluorocytosine (9/29) or amphotericin B plus fluconazole (7/29) successfully cleared the infection. Fluconazole may be a suitable alternative if 5-fluorocytosine is not readily available or not tolerated, and repetitive testing is important to reach a conclusive diagnosis in NS patients suspected of having CM.
基金：
Major National R&D Projects of the National Health Department [2018ZX10101003]; National Natural Science Foundation of China [31770161]; Shanghai Science and Technology Committee [17DZ2272900]; Shanghai Municipal Commission of Health and Family Planning [2017ZZ01024-001]; Shanghai Sailing Program [19YF1448000]; Chinese Academy of Engineering [2019-XY-33, 19-HN-XZ-06, 2020-XY-61-01]
第一作者机构：[1]Second Mil Med Univ, Shanghai Changzheng Hosp, Shanghai Key Lab Mol Med Mycol, Shanghai, Peoples R China[2]Second Mil Med Univ, Shanghai Changzheng Hosp, Dept Dermatol, Shanghai, Peoples R China
共同第一作者：
通讯作者：
通讯机构：[1]Second Mil Med Univ, Shanghai Changzheng Hosp, Shanghai Key Lab Mol Med Mycol, Shanghai, Peoples R China[2]Second Mil Med Univ, Shanghai Changzheng Hosp, Dept Dermatol, Shanghai, Peoples R China
推荐引用方式(GB/T 7714)：
Hu Dongying,Zhang Qilong,Jiang Weiwei,et al.Cryptococcal Meningitis: A Rare Complication in HIV-Negative Patients with Nephrotic Syndrome in A Chinese Teaching Hospital[J].MYCOPATHOLOGIA.2020,185(6):959-969.doi:10.1007/s11046-020-00482-5.
APA：
Hu, Dongying,Zhang, Qilong,Jiang, Weiwei,Arastehfar, Amir,Ilkit, Macit...&Liao, Wanqing.(2020).Cryptococcal Meningitis: A Rare Complication in HIV-Negative Patients with Nephrotic Syndrome in A Chinese Teaching Hospital.MYCOPATHOLOGIA,185,(6)
MLA：
Hu, Dongying,et al."Cryptococcal Meningitis: A Rare Complication in HIV-Negative Patients with Nephrotic Syndrome in A Chinese Teaching Hospital".MYCOPATHOLOGIA 185..6(2020):959-969
