Clinical characteristics and prognosis of pediatric cryptococcosis in Beijing Children’s Hospital, 2002–2014

Cryptococcosis is a rare pediatric disease. The aim of the study is to describe clinical characteristics and prognosis of pediatric cryptococcosis from 2002 to 2014 in Beijing Children’s Hospital. A total of 53 cases of cryptococcosis were identified, 69.8% of which were males. The mean age was 7 years. Forty-one (77.4%) patients had no underlying conditions. Fever, headache, and vomiting were the most common symptoms. The most common sites were the central nervous system (CNS), followed by the lungs. Most patients received a combination of amphotericin B and fluconazole with or without flucytosine as their initial regimen. Twenty-seven patients received a follow-up and six patients (22.2%) had died. The factors associated with neurological complications or death were headache (P = 0.008), seizures (P = 0.006), visual impairment (P = 0.011), neck stiffness (P = 0.008), low erythrocyte sedimentation rate (ESR) (P = 0.024), and a cerebral spinal fluid (CSF) cryptococcal antigen titer ≥ 1:1024 (P = 0.038).

Conclusions: The majority of cryptococcosis cases in China occurred in children without underlying conditions, causing multiple organ damage. The CNS was the most common site. Patients who had headaches, seizures, or high CSF antigen titers experienced neurological complications or died.