{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T10:23:44Z","timestamp":1774434224712,"version":"3.50.1"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:00:00Z","timestamp":1772236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23NS110470"],"award-info":[{"award-number":["K23NS110470"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24AI184270"],"award-info":[{"award-number":["K24AI184270"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["RF1NS145626"],"award-info":[{"award-number":["RF1NS145626"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Elevated intracranial pressure contributes to high mortality in cryptococcal meningitis. We evaluated the association between therapeutic lumbar punctures (LPs) and survival among patients hospitalized with cryptococcal meningitis in the United States. Repeat LPs were associated with lower mortality (hazard ratio [HR] 0.38; 95% confidence interval (CI), 0.29\u20130.49) overall, in people with HIV (HR 0.33; 95% CI, 0.21\u20130.50), in transplant recipients (HR 0.21; 95% CI, 0.08\u20130.58), and in persons without HIV or transplant (HR 0.44; 95% CI, 0.30\u20130.64) compared with receipt of only diagnostic LP. Findings support guideline-recommended repeat LP across diverse populations.<\/jats:p>","DOI":"10.1093\/mmy\/myag021","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T12:21:55Z","timestamp":1773058915000},"source":"Crossref","is-referenced-by-count":0,"title":["Lumbar puncture frequency and patient survival among persons hospitalized with cryptococcal meningitis in the United States"],"prefix":"10.1093","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5661-8147","authenticated-orcid":false,"given":"Madison","family":"Okuno","sequence":"first","affiliation":[{"name":"University of Minnesota Division of General Internal Medicine, Department of Medicine, , Minneapolis, Minnesota 55455 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9550-0635","authenticated-orcid":false,"given":"Elizabeth L","family":"Schwartz","sequence":"additional","affiliation":[{"name":"University of Minnesota Division of Infectious Diseases and International Medicine, Department of Medicine, , Minneapolis, Minnesota 55455 ,","place":["USA"]},{"name":"Division of Epidemiology and Community Health, School of Public Health, University of Minnesota , Minneapolis, Minnesota 55455 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0458-2493","authenticated-orcid":false,"given":"Kaitlin","family":"Benedict","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention , Atlanta, Georgia 30329 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Massey","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention , Atlanta, Georgia 30329 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R","family":"Boulware","sequence":"additional","affiliation":[{"name":"University of Minnesota Division of Infectious Diseases and International Medicine, Department of Medicine, , Minneapolis, Minnesota 55455 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy A W","family":"Gold","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention , Atlanta, Georgia 30329 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9431-8938","authenticated-orcid":false,"given":"Nathan C","family":"Bahr","sequence":"additional","affiliation":[{"name":"University of Minnesota Division of Infectious Diseases and International Medicine, Department of Medicine, , Minneapolis, Minnesota 55455 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"issue":"2","key":"2026032503520845400_bib1","doi-asserted-by":"publisher","first-page":"e56269","DOI":"10.1371\/journal.pone.0056269","article-title":"Epidemiology of cryptococcal meningitis in the US: 1997\u20132009","volume":"8","author":"Pyrgos","year":"2013","journal-title":"PLoS One"},{"issue":"1","key":"2026032503520845400_bib2","doi-asserted-by":"publisher","first-page":"ofab593","DOI":"10.1093\/ofid\/ofab593","article-title":"Prevalence and healthcare burden of fungal infections in the United States, 2018","volume":"9","author":"Rayens","year":"2022","journal-title":"Open Forum Infect Dis"},{"issue":"12","key":"2026032503520845400_bib3","doi-asserted-by":"publisher","first-page":"1237","DOI":"10.1007\/s40265-022-01757-5","article-title":"Treatment of cryptococcal meningitis: How have we got here and where are we going?","volume":"82","author":"Ngan","year":"2022","journal-title":"Drugs"},{"issue":"7","key":"2026032503520845400_bib4","doi-asserted-by":"publisher","first-page":"ofab296","DOI":"10.1093\/ofid\/ofab296","article-title":"Clinical predictors impacting cryptococcal dissemination and poor outcome in patients with cirrhosis","volume":"8","author":"Cheng","year":"2021","journal-title":"Open Forum Infect Dis"},{"issue":"1","key":"2026032503520845400_bib5","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1086\/313603","article-title":"Diagnosis and management of increased intracranial pressure in patients with AIDS and cryptococcal meningitis. The NIAID Mycoses Study Group and AIDS Cooperative Treatment Groups","volume":"30","author":"Graybill","year":"2000","journal-title":"Clin Infect Dis."},{"issue":"9","key":"2026032503520845400_bib6","doi-asserted-by":"publisher","first-page":"ofac416","DOI":"10.1093\/ofid\/ofac416","article-title":"Therapeutic lumbar punctures in human immunodeficiency virus-associated cryptococcal meningitis: Should opening pressure direct management?","volume":"9","author":"Kagimu","year":"2022","journal-title":"Open Forum Infect Dis"},{"issue":"8","key":"2026032503520845400_bib7","doi-asserted-by":"publisher","first-page":"e495","DOI":"10.1016\/s1473-3099(23)00731-4","article-title":"Global guideline for the diagnosis and management of cryptococcosis: an initiative of the ECMM and ISHAM in cooperation with the ASM","volume":"24","author":"Chang","year":"2024","journal-title":"Lancet Infect Dis"},{"key":"2026032503520845400_bib8","volume-title":"WHO Guidelines Approved by the Guidelines Review Committee. In Guidelines for Diagnosing, Preventing and Managing Cryptococcal Disease Among Adults, Adolescents and Children Living with HIV","author":"World Health Organization","year":"2022"},{"issue":"3","key":"2026032503520845400_bib9","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1086\/649858","article-title":"Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America","volume":"50","author":"Perfect","year":"2010","journal-title":"Clin Infect Dis."},{"issue":"11","key":"2026032503520845400_bib10","doi-asserted-by":"publisher","first-page":"1607","DOI":"10.1093\/cid\/ciu596","article-title":"The effect of therapeutic lumbar punctures on acute mortality from cryptococcal meningitis","volume":"59","author":"Rolfes","year":"2014","journal-title":"Clin Infect Dis."},{"issue":"6","key":"2026032503520845400_bib11","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1097\/QAD.0b013e32832605fe","article-title":"Relationship of cerebrospinal fluid pressure, fungal burden and outcome in patients with cryptococcal meningitis undergoing serial lumbar punctures","volume":"23","author":"Bicanic","year":"2009","journal-title":"AIDS"},{"issue":"1","key":"2026032503520845400_bib12","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.4102\/sajhivmed.v21i1.1171","article-title":"Intracranial pressure management in patients with human immunodeficiency virus-associated cryptococcal meningitis in a resource-constrained setting","volume":"21","author":"Mkoko","year":"2020","journal-title":"South Afr J HIV Med"},{"key":"2026032503520845400_bib13","volume-title":"Premier Healthcare Database: Data that Informs and Performs","author":"Premier Applied Sciences","year":"2024"},{"issue":"3","key":"2026032503520845400_bib14","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1093\/cid\/civ263","article-title":"Evaluation of fingerstick cryptococcal antigen lateral flow assay in HIV-infected persons: a diagnostic accuracy study","volume":"61","author":"Williams","year":"2015","journal-title":"Clin Infect Dis."}],"container-title":["Medical Mycology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/mmy\/advance-article-pdf\/doi\/10.1093\/mmy\/myag021\/67287660\/myag021.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mmy\/article-pdf\/64\/3\/myag021\/67287660\/myag021.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mmy\/article-pdf\/64\/3\/myag021\/67287660\/myag021.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T07:52:29Z","timestamp":1774425149000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/mmy\/article\/doi\/10.1093\/mmy\/myag021\/8512894"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,28]]},"references-count":14,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,2,28]]}},"URL":"https:\/\/doi.org\/10.1093\/mmy\/myag021","relation":{},"ISSN":["1369-3786","1460-2709"],"issn-type":[{"value":"1369-3786","type":"print"},{"value":"1460-2709","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,2,28]]},"article-number":"myag021"}}