{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T17:31:58Z","timestamp":1787679118186,"version":"build-2784847793"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T00:00:00Z","timestamp":1674777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cryptococcosis is traditionally associated with immunocompromised patients but is increasingly being identified in those without the human immunodeficiency virus (HIV) or other immunocompetent individuals. We aim to describe the characteristics, mortality, and associated variables with death among hospitalized patients with cryptococcosis in Brazil. This is the first multicenter retrospective cohort study conducted in seven public tertiary Brazilian hospitals. A total of 384 patients were included; the median age was 39 years and 283 (73.7%) were men. In all, 304 HIV-positive were hosts (79.2%), 16 (4.2%) solid organ transplant (SOT), and 64 (16.7%) non-HIV-positive\/non-transplant (NHNT). Central nervous system (CNS) cryptococcosis had a significantly higher number across disease categories, with 313 cases (81.5%). A total of 271 (70.6%) patients were discharged and 113 (29.4%) died during hospitalization. In-hospital mortality among HIV-positive, SOT, and NHNT was 30.3% (92\/304), 12.5% (2\/16), and 29.7% (19\/64), respectively. Induction therapy with conventional amphotericin B (AMB) mainly in combination with fluconazole (234; 84.2%) was the most used. Only 80 (22.3%) patients received an AMB lipid formulation: liposomal (n\u00a0=\u00a035) and lipid complex (n\u00a0=\u00a045). Most patients who died belong to the CNS cryptococcosis category (83\/113; 73.4%) when compared with the others (P\u00a0=\u00a0.017). Multivariate analysis showed that age and disseminated cryptococcosis had a higher risk of death (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.01\u20131.05; P\u00a0=\u00a0.008 and OR, 1.84; 95% CI, 1.01\u20133.53; P\u00a0=\u00a0.048, respectively). Understanding the epidemiology of cryptococcosis in our settings will help to recognize the burden and causes of mortality and identify strategies to improve this scenario.<\/jats:p>","DOI":"10.1093\/mmy\/myad011","type":"journal-article","created":{"date-parts":[[2023,1,28]],"date-time":"2023-01-28T08:53:14Z","timestamp":1674895994000},"source":"Crossref","is-referenced-by-count":7,"title":["Characteristics, mortality, associated variables with death, and therapeutic response among HIV-positive, solid organ transplant (SOT), and non-HIV-positive\/non-transplant (NHNT) patients with cryptococcosis: First multicenter cohort study in Brazil"],"prefix":"10.1093","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7295-0828","authenticated-orcid":false,"given":"Francelise","family":"Bridi Cavassin","sequence":"first","affiliation":[{"name":"Internal Medicine and Health Sciences Department, Universidade Federal do Paran\u00e1 (UFPR) , Curitiba , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7830-8716","authenticated-orcid":false,"given":"Jose Ernesto","family":"Vidal","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Instituto de Infectologia Em\u00edlio Ribas (IIER) , S\u00e3o Paulo , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Luiz","family":"Ba\u00fa-Carneiro","sequence":"additional","affiliation":[{"name":"Faculdades Pequeno Pr\u00edncipe (FPP) , Curitiba , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e1ssia","family":"Silva de Miranda Godoy","sequence":"additional","affiliation":[{"name":"Medical Education and Research Department, Hospital de Doen\u00e7as Tropicais Dr. Anuar Auad (HDT) , Goi\u00e2nia , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"de Bastos Ascen\u00e7o Soares","sequence":"additional","affiliation":[{"name":"Medical Education and Research Department, Hospital de Doen\u00e7as Tropicais Dr. Anuar Auad (HDT) , Goi\u00e2nia , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello Mihailenko Chaves","family":"Magri","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo (HC\/FAMUSP) , S\u00e3o Paulo , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8683-3833","authenticated-orcid":false,"given":"Diego Rodrigues","family":"Falci","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital de Cl\u00ednicas de Porto Alegre (HCPA) , Porto Alegre , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Sakuma De Oliveira","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Universit\u00e1rio do Oeste do Paran\u00e1 (HUOP) , Cascavel , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Verena Almeida Mendes","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital S\u00e3o Rafael (HSR) , Salvador , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni Lu\u00eds","family":"Breda","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital de Cl\u00ednicas da Universidade Federal do Paran\u00e1 (HC\/UFPR) , Curitiba , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline Martins","family":"Rego","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Instituto de Infectologia Em\u00edlio Ribas (IIER) , S\u00e3o Paulo , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u00edra","family":"Araujo F\u00e9lix","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Instituto de Infectologia Em\u00edlio Ribas (IIER) , S\u00e3o Paulo , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Pacheco Katopodis","sequence":"additional","affiliation":[{"name":"Medical Education and Research Department, Pontif\u00edcia Universidade Cat\u00f3lica de Goi\u00e1s , Goi\u00e2nia , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia Raquel","family":"da Silva do \u00d3","sequence":"additional","affiliation":[{"name":"Medical Education and Research Department, Pontif\u00edcia Universidade Cat\u00f3lica de Goi\u00e1s , Goi\u00e2nia , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirela","family":"Pereira Lima Abr\u00e3o","sequence":"additional","affiliation":[{"name":"Medical Education and Research Department, Universidade Federal de Goi\u00e1s , Goi\u00e2nia , 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