Cerebrospinal fluid shunting for the management of cryptococcal meningitis: a scoping review.

Autor:	Cornejo-Venegas G; Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru., Carreras X; Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru., Salcedo AS; Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru., Soriano-Moreno DR; Unidad de Investigación Clínica y Epidemiológica, Escuela de Medicina, Universidad Peruana Unión, Lima, Peru., Salinas JL; Division of Infectious Diseases & Geographic Medicine, Stanford University, CA, USA., Alave J; Escuela de Medicina, Universidad Peruana Unión, Carretera Central Km 19.5 Ñaña, Chosica, Lima 15464, Peru.
Jazyk:	angličtina
Zdroj:	Therapeutic advances in infectious disease [Ther Adv Infect Dis] 2024 Feb 07; Vol. 11, pp. 20499361241228666. Date of Electronic Publication: 2024 Feb 07 (Print Publication: 2024).
DOI:	10.1177/20499361241228666
Abstrakt:	Objective: This scoping review aimed to describe studies that evaluate the management of cryptococcal meningitis (CM) using cerebrospinal fluid (CSF) shunts, types of shunts used, and clinically relevant patient outcomes. Methods: We searched in the following databases: PubMed, Web of Science/Core collection, Embase, the Cochrane Library, and clinicaltrials.gov on 1 April 2022. We included two-arm and one-arm cohort studies that evaluated clinically relevant patient outcomes. Case reports were used to describe the type of CSF shunts used and the rationale behind its selection. The selection and extraction processes were independently performed by two authors. Results: This study included 20 cohort studies and 26 case reports. Only seven cohort studies compared two groups. Ventriculoperitoneal shunt was the most commonly used type of shunt (82.1%). The main indications for placing a shunt were persistently high opening pressure (57.1%) and persisting neurological symptoms or deterioration (54.3%). Cohort studies suggest that patients with shunt showed improvement in some outcomes such as neurological symptoms and hospital stay length. The most common shunt complications were post-operative fever (1-35.6%) and shunt obstruction (7-16%). Conclusion: CSF shunts may improve some clinically relevant outcomes in patients with CM, but the evidence is very uncertain. Competing Interests: The authors declare that there is no conflict of interest. (© The Author(s), 2024.)
Databáze:	MEDLINE
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