{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T03:51:38Z","timestamp":1792468298855,"version":"4.5.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T00:00:00Z","timestamp":1685059200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients without human immunodeficiency virus (HIV) are increasingly recognized as being at risk for cryptococcosis. Knowledge of characteristics of cryptococcosis in these patients remains incomplete.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective study of cryptococcosis in 46 Australian and New Zealand hospitals to compare its frequency in patients with and without HIV and describe its characteristics in patients without HIV. Patients with cryptococcosis between January 2015 and December 2019 were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 475 patients with cryptococcosis, 90% were without HIV (426 of 475) with marked predominance in both Cryptococcus neoformans (88.7%) and Cryptococcus gattii cases (94.3%). Most patients without HIV (60.8%) had a known immunocompromising condition: cancer (n = 91), organ transplantation (n = 81), or other immunocompromising condition (n = 97). Cryptococcosis presented as incidental imaging findings in 16.4% of patients (70 of 426). The serum cryptococcal antigen test was positive in 85.1% of tested patients (319 of 375); high titers independently predicted risk of central nervous system involvement. Lumbar puncture was performed in 167 patients to screen for asymptomatic meningitis, with a positivity rate of 13.2% where meningitis could have been predicted by a high serum cryptococcal antigen titer and\/or fungemia in 95% of evaluable cases. One-year all-cause mortality was 20.9% in patients without HIV and 21.7% in patients with HIV (P = .89).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Ninety percent of cryptococcosis cases occurred in patients without HIV (89% and 94% for C. neoformans and C. gattii, respectively). Emerging patient risk groups were evident. A high level of awareness is warranted to diagnose cryptococcosis in patients without HIV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciad321","type":"journal-article","created":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T20:34:53Z","timestamp":1685046893000},"page":"976-986","source":"Crossref","is-referenced-by-count":61,"title":["Current Epidemiology and Clinical Features of\n                    <i>Cryptococcus<\/i>\n                    Infection in Patients Without Human Immunodeficiency Virus: A Multicenter Study in 46 Hospitals in Australia and New Zealand"],"prefix":"10.1093","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4302-6599","authenticated-orcid":false,"given":"Julien","family":"Coussement","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Peter MacCallum Cancer Centre , Melbourne, Victoria , Australia"},{"name":"Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher H","family":"Heath","sequence":"additional","affiliation":[{"name":"Department of Microbiology, PathWest Laboratory Medicine, Fiona Stanley Hospital , Murdoch, Washington , Australia"},{"name":"Department of Infectious Diseases, Fiona Stanley Hospital , Murdoch, Western Australia , Australia"},{"name":"Department of Infectious Diseases, Royal Perth Hospital , Perth, Western Australia , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew B","family":"Roberts","sequence":"additional","affiliation":[{"name":"Royal Adelaide Hospital , Adelaide, South Australia , Australia"},{"name":"Flinders Medical Centre , Bedford Park, South Australia , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebekah J","family":"Lane","sequence":"additional","affiliation":[{"name":"Te Toka Tumai , Auckland , New 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