{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:42:32Z","timestamp":1784248952092,"version":"3.55.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2019,9,4]],"date-time":"2019-09-04T00:00:00Z","timestamp":1567555200000},"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\/501100001809","name":"National Natural Science Foundation","doi-asserted-by":"crossref","award":["81301459"],"award-info":[{"award-number":["81301459"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004731","name":"Natural Science Foundation of Zhejiang Province","doi-asserted-by":"publisher","award":["LQ13H190001"],"award-info":[{"award-number":["LQ13H190001"]}],"id":[{"id":"10.13039\/501100004731","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Medical Science and Technology Project of Zhejiang Province","award":["2014KYB096"],"award-info":[{"award-number":["2014KYB096"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Cryptococcemia is a life-threatening fungal infection. Sometimes, it is hard to diagnose. The studies to describe the characteristics of cryptococcemia specifically were limited. We performed this retrospective analysis in a Chinese hospital during 2002\u20132015, including 85 cryptococcemia cases and 52 Cryptococcus spp. isolates. The species, mating type, antifungal susceptibility and multilocus sequence typing of Cryptococcus spp. were determined. C. neoformans var. grubii MAT\u03b1 of sequence type (ST) 5 is the representative strain of cryptococcemia, accounting for 51 isolates. The MIC50\/90 values were 0.5\/0.5, 1.0\/1.0, 2.0\/4.0, \u22640.06\/0.25, and \u22640.06\/\u22640.06\u00a0\u03bcg\/ml for amphotericin B, flucytosine, fluconazole, itraconazole, and voriconazole, respectively. Cryptococcemia was the first diagnostic proof of cryptococcosis in 37 patients (43.5%, 37\/85). Compared with the patients initially diagnosed of cryptococcosis in other sites (mainly cerebrospinal fluid), the patients firstly diagnosed by blood culture had prolonged time from admission to diagnosis of cryptococcosis (9 days vs. 2 days, P &amp;lt; .001) and higher 30-day mortality (54.1%\u00a0vs. 20.8%, P = .003), while fewer symptoms of meningitis (45.9%\u00a0vs. 100%, P &amp;lt; .001). For the patients receiving lumbar puncture, the occurrence of meningitis was similar between the patients firstly diagnosed by blood culture and those firstly diagnosed in other sites (94.1%\u00a0vs. 100%, P = .26). However, the patients first diagnosed by blood culture had lower baseline intracranial pressure (250 mm H2O vs. 342.5 mm H2O, P = .001). In conclusion, patients with cryptococcemia as the first diagnostic proof of cryptococcosis usually had neglected subtle symptoms of meningitis, which may result in delayed diagnosis and catastrophic outcome.<\/jats:p>","DOI":"10.1093\/mmy\/myz089","type":"journal-article","created":{"date-parts":[[2019,8,8]],"date-time":"2019-08-08T19:11:43Z","timestamp":1565291503000},"page":"478-484","source":"Crossref","is-referenced-by-count":11,"title":["Microbiological and clinical characteristics of cryptococcemia: a retrospective analysis of 85 cases in a Chinese hospital"],"prefix":"10.1093","volume":"58","author":[{"given":"Yiqi","family":"Fu","sequence":"first","affiliation":[{"name":"Department of Respiratory Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Xu","sequence":"first","affiliation":[{"name":"Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Center of Clinical Laboratory, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Respiratory Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yake","family":"Yao","sequence":"first","affiliation":[{"name":"Department of Respiratory Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianying","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Respiratory Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhijie","family":"Pan","sequence":"first","affiliation":[{"name":"Department of Respiratory Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,9,4]]},"reference":[{"key":"2020053120001016000_bib1","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1097\/00005792-198303000-00003","article-title":"Cryptococcemia","volume":"62","author":"Perfect","year":"1983","journal-title":"Medicine (Baltimore)"},{"key":"2020053120001016000_bib2","doi-asserted-by":"crossref","first-page":"176","DOI":"10.7326\/0003-4819-80-2-176","article-title":"Prognostic factors in cryptococcal meningitis: a study in 111 cases","volume":"80","author":"Diamond","year":"1974","journal-title":"Ann Intern Med"},{"key":"2020053120001016000_bib3","doi-asserted-by":"crossref","first-page":"e60431","DOI":"10.1371\/journal.pone.0060431","article-title":"Predictors of mortality and differences in clinical features among patients with cryptococcosis according to immune status","volume":"8","author":"Brizendine","year":"2013","journal-title":"PLoS One"},{"key":"2020053120001016000_bib4","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1111\/myc.12847","article-title":"Fluconazole resistance is not a predictor of poor outcome in patients with cryptococcosis","volume":"62","author":"Vena","year":"2019","journal-title":"Mycoses"},{"key":"2020053120001016000_bib5","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1093\/qjmed\/95.8.511","article-title":"Cryptococcaemia: clinical features and prognostic factors","volume":"95","author":"Jean","year":"2002","journal-title":"QJM"},{"key":"2020053120001016000_bib6","first-page":"143","article-title":"Cryptococcemia: an analysis of 28 cases with emphasis on the clinical outcome and its etiologic agent","volume":"21","author":"Pasqualotto","year":"2004","journal-title":"Rev Iberoam Micol"},{"key":"2020053120001016000_bib7","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s10096-014-2218-4","article-title":"Evaluation of blood culture media for the detection of fungi","volume":"34","author":"Nawrot","year":"2015","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2020053120001016000_bib8","doi-asserted-by":"crossref","first-page":"2522","DOI":"10.1128\/JCM.00502-11","article-title":"Rapid identification of Cryptococcus neoformans var. grubii, C. neoformans var. neoformans, and C. gattii by use of rapid biochemical tests, differential media, and DNA sequencing","volume":"49","author":"McTaggart","year":"2011","journal-title":"J Clin Microbiol"},{"key":"2020053120001016000_bib9","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1128\/IAI.69.1.115-122.2001","article-title":"Serotype AD strains of Cryptococcus neoformans are diploid or aneuploid and are heterozygous at the mating-type locus","volume":"69","author":"Lengeler","year":"2001","journal-title":"Infect Immun"},{"key":"2020053120001016000_bib10","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1080\/13693780902953886","article-title":"Consensus multi-locus sequence typing scheme for Cryptococcus neoformans and Cryptococcus gattii","volume":"47","author":"Meyer","year":"2009","journal-title":"Med Mycol"},{"key":"2020053120001016000_bib11","doi-asserted-by":"crossref","first-page":"3107","DOI":"10.1128\/AAC.06252-11","article-title":"Cryptococcus neoformans-Cryptococcus gattii species complex: an international study of wild-type susceptibility endpoint distributions and epidemiological cutoff values for amphotericin B and flucytosine","volume":"56","author":"Espinel-Ingroff","year":"2012","journal-title":"Antimicrob Agents Chemother"},{"key":"2020053120001016000_bib12","doi-asserted-by":"crossref","first-page":"5898","DOI":"10.1128\/AAC.01115-12","article-title":"Cryptococcus neoformans-Cryptococcus gattii species complex: an international study of wild-type susceptibility endpoint distributions and epidemiological cutoff values for fluconazole, itraconazole, posaconazole, and voriconazole","volume":"56","author":"Espinel-Ingroff","year":"2012","journal-title":"Antimicrob Agents Chemother"},{"key":"2020053120001016000_bib13","doi-asserted-by":"crossref","first-page":"e881","DOI":"10.1016\/j.cmi.2016.07.008","article-title":"Predominance of Cryptococcus neoformans var. grubii multilocus sequence type 5 and emergence of isolates with non-wild-type minimum inhibitory concentrations to fluconazole: a multi-centre study in China","volume":"22","author":"Fan","year":"2016","journal-title":"Clin Microbiol Infect"},{"key":"2020053120001016000_bib14","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1111\/myc.12312","article-title":"Molecular characterisation of clinical Cryptococcus neoformans and Cryptococcus gattii isolates from Sichuan province, China","volume":"58","author":"Wu","year":"2015","journal-title":"Mycoses"},{"key":"2020053120001016000_bib15","doi-asserted-by":"crossref","first-page":"755","DOI":"10.3201\/eid1405.071312","article-title":"Cryptococcus neoformans strains and infection in apparently immunocompetent patients, China","volume":"14","author":"Chen","year":"2008","journal-title":"Emerg Infect Dis"},{"key":"2020053120001016000_bib16","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1007\/s10096-014-2289-2","article-title":"Molecular epidemiology of Cryptococcus neoformans and Cryptococcus gattii in China between 2007 and 2013 using multilocus sequence typing and the DiversiLab system","volume":"34","author":"Dou","year":"2015","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2020053120001016000_bib17","doi-asserted-by":"crossref","first-page":"e0005628","DOI":"10.1371\/journal.pntd.0005628","article-title":"Comparative genomics of Cryptococcus neoformans var. grubii associated with meningitis in HIV infected and uninfected patients in Vietnam","volume":"11","author":"Day","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"2020053120001016000_bib18","doi-asserted-by":"crossref","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"},{"key":"2020053120001016000_bib19","doi-asserted-by":"crossref","first-page":"565","DOI":"10.2217\/fmb.14.132","article-title":"Host immunity to Cryptococcus neoformans","volume":"10","author":"Rohatgi","year":"2015","journal-title":"Future Microbiol"},{"key":"2020053120001016000_bib20","first-page":"278","article-title":"Unique characteristics of cryptococcosis identified after death in patients with liver cirrhosis: comparison with concurrent cohort diagnosed antemortem","volume":"55","author":"Singh","year":"2017","journal-title":"Med Mycol"},{"key":"2020053120001016000_bib21","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1016\/j.cmi.2016.04.022","article-title":"Cryptococcosis: the impact of delay to diagnosis","volume":"22","author":"Aye","year":"2016","journal-title":"Clin Microbiol Infect"}],"container-title":["Medical Mycology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/mmy\/article-pdf\/58\/4\/478\/33196601\/myz089.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/mmy\/article-pdf\/58\/4\/478\/33196601\/myz089.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T00:00:49Z","timestamp":1590969649000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/mmy\/article\/58\/4\/478\/5560180"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,4]]},"references-count":21,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,9,4]]},"published-print":{"date-parts":[[2020,6,1]]}},"URL":"https:\/\/doi.org\/10.1093\/mmy\/myz089","relation":{},"ISSN":["1369-3786","1460-2709"],"issn-type":[{"value":"1369-3786","type":"print"},{"value":"1460-2709","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,6]]},"published":{"date-parts":[[2019,9,4]]}}}