{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T15:55:48Z","timestamp":1784908548064,"version":"3.55.0"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,6,19]],"date-time":"2020-06-19T00:00:00Z","timestamp":1592524800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,6,19]],"date-time":"2020-06-19T00:00:00Z","timestamp":1592524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cryptococcal meningitis is the most common intracranial infectious fungal disease. After a period of antifungal treatment, as the number of cells in the cerebrospinal fluid decreases, the biochemical indexes improve and the number of cryptococcus reduces, the patient\u2019s condition suddenly worsen. Most of the symptoms are severe headache, raised intracranial pressure, together with impaired clinical nerve function. These presentations are often mistaken for a failure of antifungal treatment. In fact it\u2019s an encephalitis syndrome which is unrecognized by most clinicians: Immune reconstitution inflammatory syndrome (IRIS). To increase awareness we retrospectively analyzed clinical data of 100 cases of cryptococcal neoformans meningitis, among which 26 patients develop CM-IRIS. All patients have been divided into three groups: Group 1, patients who were not treated with glucocorticoid and didn\u2019t experienced IRIS; Group 2, patients who were not treated with glucocorticoid although developed CM-IRIS; Group 3, patients started treatment with glucocorticoid for two weeks with new onset CM-IRIS. Compared with the group treated with glucocorticoid, treatment without glucocorticoid was subjected to a higher risk of incident IRIS. The difference was statistically significant (P\u2009&lt;\u20090.05). Imaging findings demonstrated diseased area of the white matter area, and it looked like commonly in the supratentorial region. Moreover, if it appears in the infratentorial region then must be combined with supratentorial region.<\/jats:p>","DOI":"10.1038\/s41598-020-67031-4","type":"journal-article","created":{"date-parts":[[2020,6,19]],"date-time":"2020-06-19T10:03:27Z","timestamp":1592561007000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Clinical and Radiographic Features of Cryptococcal Neoformans Meningitis-associated Immune Reconstitution Inflammatory Syndrome"],"prefix":"10.1038","volume":"10","author":[{"given":"Gang","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiumei","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhijian","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,6,19]]},"reference":[{"issue":"6","key":"67031_CR1","doi-asserted-by":"publisher","first-page":"447","DOI":"10.7326\/0003-4819-133-6-200009190-00013","volume":"133","author":"JA DeSimone","year":"2000","unstructured":"DeSimone, J. A., Pomerantz, R. J. & Babinchak, T. J. Inflammatory reactions in HIV-1\u2013infected persons after initiation of highly active antiretroviral therapy.J. Annals of internal medicine. 133(6), 447\u2013454 (2000).","journal-title":"Annals of internal medicine."},{"issue":"4","key":"67031_CR2","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1097\/QCO.0b013e32832d7aff","volume":"22","author":"HY Sun","year":"2009","unstructured":"Sun, H. Y. & Singh, N. Immune reconstitution inflammatory syndrome in non-HIV immunocompromised patients. J. Current opinion in infectious diseases 22(4), 394\u2013402 (2009).","journal-title":"J. Current opinion in infectious diseases"},{"key":"67031_CR3","doi-asserted-by":"crossref","unstructured":"Eduardo Rodrigues da Cunha Colombo Delio Jos\u00e9 Mora Mario Le\u00f3n Silva\u2010Vergara. Immune reconstitution inflammatory syndrome (IRIS) associated with Cryptococcus neoformans infection in AIDS patients.J. Mycoses. 54: 178-182(2010).","DOI":"10.1111\/j.1439-0507.2010.01870.x"},{"key":"67031_CR4","first-page":"1049","volume":"40","author":"SA Shelburne III","year":"2005","unstructured":"Shelburne, S. A. III et al. The Role of Immune Reconstitution Inflammatory Syndrome in AIDS-Related Cryptococcus neoformans Disease in the Era of Highly. Active Antiretroviral Therapy J. HIV\/AIDS. 40, 1049\u20131052 (2005).","journal-title":"Active Antiretroviral Therapy J. HIV\/AIDS."},{"key":"67031_CR5","doi-asserted-by":"publisher","first-page":"1443","DOI":"10.1086\/503570","volume":"42","author":"IZ Ecevit","year":"2006","unstructured":"Ecevit, I. Z. et al. The poor prognosis of central nervous system cryptococcosis among nonimmunosuppressed patients: a call for better disease recognition and evaluation of adjuncts to antifungal therapy. Clin Infect Dis 42, 1443\u20131447 (2006).","journal-title":"Clin Infect Dis"},{"issue":"5","key":"67031_CR6","doi-asserted-by":"publisher","first-page":"1004884","DOI":"10.1371\/journal.ppat.1004884","volume":"11","author":"AA Panackal","year":"2015","unstructured":"Panackal, A. A. et al. Paradoxical Immune Responses in Non-HIV Cryptococcal Meningitis.J. PLOS Pathogens. 11(5), 1004884 (2015).","journal-title":"PLOS Pathogens."},{"issue":"3","key":"67031_CR7","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1086\/649858","volume":"50","author":"JR Perfect","year":"2010","unstructured":"Perfect, J. R. et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America. J. Clinical Infectious Diseases. 50(3), 291\u2013322 (2010).","journal-title":"J. Clinical Infectious Diseases."},{"key":"67031_CR8","doi-asserted-by":"crossref","unstructured":"Azure T. M, G McHugh, New Approaches to the Diagnosis and Treatment of Cryptococcal Meningitis, Seminars in Neurology. 34 (1):47-60(2014).","DOI":"10.1055\/s-0034-1372342"},{"issue":"6","key":"67031_CR9","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/S1473-3099(07)70085-3","volume":"7","author":"N Singh","year":"2007","unstructured":"Singh, N. & Perfect, J. R. Immune reconstitution syndrome associated with opportunistic mycoses.J. The Lancet infectious diseases. 7(6), 395\u2013401 (2007).","journal-title":"The Lancet infectious diseases."},{"issue":"14","key":"67031_CR10","doi-asserted-by":"publisher","first-page":"1291","DOI":"10.1056\/NEJMoa1110404","volume":"368","author":"JN Day","year":"2013","unstructured":"Day, J. N. et al. Combination antifungal therapy for cryptococcal meningitis.J. 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AIDS. 27(13), 2089\u20132099 (2013).","journal-title":"AIDS."},{"issue":"8","key":"67031_CR13","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1097\/NEN.0b013e318181b4da","volume":"67","author":"EJ Rushing","year":"2008","unstructured":"Rushing, E. J. et al. Immune reconstitution inflammatory syndrome of the brain: case illustrations of a challenging entity.J. Journal of Neuropathology & Experimental Neurology. 67(8), 819\u2013827 (2008).","journal-title":"Journal of Neuropathology & Experimental Neurology."},{"key":"67031_CR14","doi-asserted-by":"publisher","first-page":"e128","DOI":"10.1086\/344467","volume":"35","author":"ER Jenny-Avital","year":"2002","unstructured":"Jenny-Avital, E. R. & Abadi, M. Immune reconstitution cryptococcosis after initiation of successful highly active antiretroviral therapy. 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