https://scholars.lib.ntu.edu.tw/handle/123456789/522039
標題: | Cryptococcosis and tuberculosis co-infection at a university hospital in Taiwan, 1993-2006 | 作者: | CHUN-TA HUANG Tsai Y.-J. Fan J.-Y. SHIH-CHI KU CHONG-JEN YU |
公開日期: | 2010 | 卷: | 38 | 期: | 5 | 起(迄)頁: | 373-379 | 來源出版物: | Infection | 摘要: | Background: The human immunodeficiency virus (HIV) epidemic and increasing use of immunosuppressive agents have increased the prevalence of both cryptococcosis and tuberculosis (TB). However, the status of co-infection with both pathogens remains unknown. Methods: This study retrospectively reviewed patient records of cryptococcosis and TB co-infection from 1993 to 2006. The temporal sequence of co-infection was defined as either concurrent or sequential. Data collected included patient demographics, HIV status, co-morbidities, clinical manifestations, treatment strategies, and outcome at 1-year follow-up. Results: There were 23 patients with cryptococcosis and TB co-infection, representing 5.4% of cryptococcosis or 0.6% of TB cases. Eleven (48%) patients were HIV-infected, and no underlying disease or immunocompromised state could be identified in six (26%) patients. Twelve (52%) patients presented with concurrent infection, but diagnosis of co-infection could be achieved simultaneously in only three (13%). Constitutional symptoms, particularly fever and weight loss, were the most common presenting symptoms, developing in more than two-thirds of the patients. The majority (83%) of the patients made a good recovery following dual antifungal and anti-TB therapy. There were three mortalities at the 1-year follow-up, which might be attributable to a delay in diagnosis and treatment of co-infection. The outcomes of HIV-infected and non-HIV-infected patients were not significantly different. Conclusions: Cryptococcosis and TB co-infection, although rare, develops in both immunocompromised and healthy individuals. Early diagnosis and treatment may improve patient prognosis. There should be a high index of suspicion in order to achieve a timely diagnosis in a TB endemic area. ? 2010 Urban & Vogel. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-77957672843&doi=10.1007%2fs15010-010-0045-9&partnerID=40&md5=9fb0f4e5691f1dafe1c4a665dd873a49 https://scholars.lib.ntu.edu.tw/handle/123456789/522039 |
ISSN: | 0300-8126 | DOI: | 10.1007/s15010-010-0045-9 | SDG/關鍵字: | amphotericin B; antifungal agent; ethambutol; fluconazole; flucytosine; isoniazid; pyrazinamide; rifabutin; rifampicin; tuberculostatic agent; adult; aged; article; clinical article; clinical feature; comorbidity; controlled study; delayed diagnosis; demography; female; fever; follow up; human; Human immunodeficiency virus infected patient; Human immunodeficiency virus infection; human tissue; immunocompromised patient; lung tuberculosis; male; medical record; mixed infection; mortality; pulmonary cryptococcosis; retrospective study; Taiwan; treatment outcome; university hospital; weight reduction; Adult; Aged; Anti-Infective Agents; Cryptococcosis; Cryptococcus neoformans; Female; HIV Infections; Hospitals, University; Humans; Male; Middle Aged; Retrospective Studies; Taiwan; Tuberculosis |
顯示於: | 醫學系 |
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