{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:14:39Z","timestamp":1753877679187,"version":"3.41.2"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T00:00:00Z","timestamp":1726790400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Veterans Affairs Council of Taiwan","award":["VAC 112-001"],"award-info":[{"award-number":["VAC 112-001"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Cryptococcal meningitis (CM) is a severe central nervous system infection. In patients with HIV infections and coexisting CM, elevated baseline cerebrospinal fluid (CSF) lactate levels can predict increased mortality. However, the CSF lactate level's significance in patients with CM who are HIV negative remains unclear, necessitating further investigation to elucidate the potential distinctions and enhance patient management. This study investigated the significance of CSF lactate levels in patients with CM who were HIV negative.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This retrospective study utilized data from the clinical databases of patients who underwent lumbar punctures at a medical center in Kaohsiung City, southern Taiwan. Demographic data, CSF lactate levels, routine CSF analyses, and hematologic and neurologic findings were evaluated. The optimal CSF lactate threshold value was determined by the Youden index.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>This retrospective study included 70 patients with CM, among whom 44 (63%) and 26 (37%) tested negative and positive for HIV, respectively. The group without HIV exhibited higher CSF lactate levels, with an optimal CSF lactate cutoff point of 7.935\u2005mmol\/L for predicting 90-day mortality, resulting in significant predictive accuracies (area under the curve, 0.755; sensitivity, 57.1%; specificity, 100%); this value was an independent mortality predictor in patients who were HIV negative. In patients with CM who were HIV negative, CSF lactate levels \u22657.935\u2005mmol\/L correlated with higher mortality rates but without statistical significance. All patients with CM who were HIV negative and had CSF lactate levels \u22657.935\u2005mmol\/L died within 3 months of admission.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Patients with CM who were HIV negative had elevated CSF lactate levels that correlated with adverse outcomes, enabling early identification of high-risk individuals.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofae540","type":"journal-article","created":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T18:36:28Z","timestamp":1726857388000},"source":"Crossref","is-referenced-by-count":0,"title":["Cerebrospinal Fluid Lactate Levels as a Prognostic Indicator in Patients With Cryptococcal Meningitis Who Are HIV Negative: A Retrospective Cohort Study"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8196-7800","authenticated-orcid":false,"given":"Yu-Chi","family":"Tsai","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital , Kaohsiung ,","place":["Taiwan"]},{"name":"Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center , Taipei ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao-Shen","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan"},{"name":"Department of Administration, Kaohsiung Veterans General Hospital , Kaohsiung ,","place":["Taiwan"]},{"name":"Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University , Taipei ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cai-Sin","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Business Management, National Sun Yat-Sen University , Kaohsiung ,","place":["Taiwan"]},{"name":"Department of Medical Education and Research, Kaohsiung Veterans General Hospital , Kaohsiung ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ren-In","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Medical Education and Research, Kaohsiung Veterans General Hospital , Kaohsiung ,","place":["Taiwan"]},{"name":"Department of Emergency Medicine, Veterans General Hospital , Kaohsiung ,","place":["Taiwan"]},{"name":"Institute of Medicine, Chung Shan Medical University , Taichung ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ning-Chi","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center , Taipei ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jui-Kuang","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan"},{"name":"School of Nursing, Fooyin University , Kaohsiung ,","place":["Taiwan"]},{"name":"School of Medicine, National Defense Medical Center , Taipei ,","place":["Taiwan"]},{"name":"School of Medicine, College of Medicine, National Sun Yat-sen University , Kaohsiung 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