Therapeutic Lumbar Punctures in Human Immunodeficiency Virus-Associated Cryptococcal Meningitis: Should Opening Pressure Direct Management?

ABSTRACT:

Background

Increased intracranial pressure (ICP) frequently complicates cryptococcal meningitis. Therapeutic lumbar punctures (LPs) have acute survival benefits in the first week, and we sought to understand the longer-term survival impact of therapeutic LPs.

Methods

We prospectively enrolled human immunodeficiency virus (HIV)-seropositive adults with cryptococcal meningitis from 2013 to 2017 in Uganda. We assessed the association between clinical characteristics, CSF parameters, and 14- and 30-day mortality by baseline ICP. We also assessed 30-day mortality by number of follow-up therapeutic LPs performed within 7 days.

Results

Our analysis included 533 participants. Participants with baseline ICP >350 mm H₂O were more likely to have Glasgow Coma Scale (GC

SUBMITTER: Kagimu E 

PROVIDER: S-EPMC9454029 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature