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European Journal of Clinical Microbiology & Infectious Diseases

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01-12-2021 | Systemic Lupus Erythematosus | Original Article

The prevalence and mortality of cryptococcal meningitis in patients with autoimmune diseases: a systematic review and meta-analysis

Authors: Jing Zhao, Weipin Weng, Chunli Chen, Jie Zhang

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 12/2021

Abstract

Growing evidence suggests that autoimmune diseases (AIDs) are risk factors for cryptococcal meningitis (CM). Therefore, understanding the epidemiological and clinical profile of CM in patients with AIDs is important. This meta-analysis assessed the prevalence, clinical profiles, and clinical outcomes of CM in AIDs. Studies on CM in patients with AIDs were searched for in PubMed, EMBASE, Web of Science, and China National Knowledge Infrastructure, and meta-analyses were performed using the statistical program of R. Nineteen studies with 36,631 patients with AIDs were analyzed. The overall pooled CM prevalence was 0.4% (95% confidence interval [CI], 0.3–0.6%), 90.7% of which occurred in female patients. Thirteen studies with 77 patients with AIDs diagnosed with CM were analyzed, and the mortality rate was 26.7% (95% CI, 9.5–47.2%). Of patients with systemic lupus erythematosus, 30.1% of CM cases were initially misdiagnosed (95% CI, 0–65.6%). The primary symptom of CM with AIDs was headache (99.4%; 95% CI, 92.1–100%), followed by fever (93.7%; 95% CI, 82.8–100%) and vomiting (37.2%; 95% CI, 13.2–61.2%). The prevalence of CM infections among patients with AIDs should not be underestimated despite non-specific clinical presentations as there were fatal outcomes. Our results suggest that more research is needed to understand the relationship between AIDs and CM, and clinical trials are necessary to improve treatment strategies.

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Title: The prevalence and mortality of cryptococcal meningitis in patients with autoimmune diseases: a systematic review and meta-analysis
Authors: Jing Zhao
Weipin Weng
Chunli Chen
Jie Zhang
Publication date: 01-12-2021
Publisher: Springer Berlin Heidelberg
Keywords: Systemic Lupus Erythematosus
Cryptococcosis
Meningitis
Rheumatoid Arthritis
Human Immunodeficiency Virus
Published in: European Journal of Clinical Microbiology & Infectious Diseases / Issue 12/2021
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI: https://doi.org/10.1007/s10096-021-04293-4

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