AI Article Synopsis
- - The review addresses the challenges in diagnosing and treating patients with a history of cryptococcal meningitis who experience recurring symptoms after improvement, highlighting significant gaps in current medical knowledge.
- - The authors analyzed data from 28 cases of paradoxical immune reconstitution inflammatory syndrome (IRIS) and 81 cases of microbiological relapse, finding that traditional indicators like CD4 and cerebrospinal fluid white cell counts are insufficient for differentiating between these two conditions.
- - They emphasize that cryptococcal antigen tests are inadequate for distinguishing relapse from other recurrent symptoms, urging the need for newer research definitions and the development of fast, reliable diagnostic tests.
Article Abstract
Purpose Of Review: This review highlights the difficulties in diagnosing and treating persons with a prior history of cryptococcal meningitis who improve but suffer from a recurrence of symptoms. This scenario is well known to those who frequently care for patients with cryptococcal meningitis but is not well understood. We highlight major gaps in knowledge.
Recent Findings: We recently summarized our experience with 28 persons with paradoxical immune reconstitution inflammatory syndrome (IRIS) and 81 persons with microbiological relapse. CD4 count and cerebrospinal fluid white blood cell count were higher in IRIS than relapse but neither was reliable enough to routinely differentiate these conditions. Second-episode cryptococcal meningitis remains a difficult clinical scenario as cryptococcal antigen, while excellent for initial diagnosis has no value in differentiating relapse of infection from other causes of recurrent symptoms. Updated research definitions are proposed and rapid, accurate diagnostic tests are urgently needed.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11016006 | PMC |
| http://dx.doi.org/10.1007/s11904-024-00691-3 | DOI Listing |
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