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Erschienen in: European Journal of Clinical Microbiology & Infectious Diseases 12/2021

14.07.2021 | Original Article

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

verfasst von: Jing Zhao, Weipin Weng, Chunli Chen, Jie Zhang

Erschienen in: European Journal of Clinical Microbiology & Infectious Diseases | Ausgabe 12/2021

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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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Metadaten
Titel
The prevalence and mortality of cryptococcal meningitis in patients with autoimmune diseases: a systematic review and meta-analysis
verfasst von
Jing Zhao
Weipin Weng
Chunli Chen
Jie Zhang
Publikationsdatum
14.07.2021
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Clinical Microbiology & Infectious Diseases / Ausgabe 12/2021
Print ISSN: 0934-9723
Elektronische ISSN: 1435-4373
DOI
https://doi.org/10.1007/s10096-021-04293-4

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