| Autor: |
Chih-Wei Hung, Wei-Che Lin, Wen-Neng Chang, Tsung-Ming Su, Chia-Te Kung, Nai-Wen Tsai, Hung-Chen Wang, Chih-Cheng Huang, Ben-Chung Cheng, Yu-Jih Su, Ya-Ting Chang, Chih-Min Su, Sheng-Yuan Hsiao, Cheng-Hsien Lu |
| Jazyk: |
angličtina |
| Rok vydání: |
2018 |
| Předmět: |
|
| Zdroj: |
Journal of Microbiology, Immunology and Infection, Vol 51, Iss 4, Pp 545-551 (2018) |
| Druh dokumentu: |
article |
| ISSN: |
1684-1182 |
| DOI: |
10.1016/j.jmii.2017.06.002 |
| Popis: |
Purpose: Shunt procedures used to treat cryptococcal meningitis complicated with hydrocephalus and/or increased intracranial pressure (IICP) could result in cerebrospinal fluid (CSF) overdrainage, thereby presenting therapeutic challenges. Methods: We analyzed the clinical features and neuroimaging findings after the ventriculoperitoneal (VP) shunt procedure in 51 HIV (Human Immunodeficiency Virus)-negative patients with cryptococcal meningitis, to assess the risk factors associated with post-shunt CSF overdrainage. Results: Symptomatic CSF overdrainage occurred in 12% (6/51) of patients with cryptococcal meningitis who underwent the shunt procedure. Rapid deterioration of neurological conditions was found in 6 patients after the shunt procedure was performed, including disturbed consciousness, quadriparesis, and dysphasia in 5 patients and severe ataxia in 1. The mean duration of CSF overdrainage after the shunting procedure was 2–7 days (mean 4 days). The mean interval between meningitis onset to shunting procedure remained independently associated with CSF overdrainage, and the cut-off value for predicting CSF overdrainage in interval between meningitis onset to shunting procedure was 67.5 days. Conclusions: CSF overdrainage after the VP shunt procedure is not rare, especially in patients with a high-risk of cryptococcal meningitis who also have a prolonged duration of hydrocephalus and/or IICP. Keywords: CSF overdrainage, HIV-Negative cryptococcal meningitis, Outcome, Risk factor, Ventriculoperitoneal shunt procedures |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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