{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T14:46:23Z","timestamp":1787409983840,"version":"build-2736575974"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Infections due to Cryptococcus species occur globally, mostly reported as central nervous system (CNS) infection among persons with HIV infection. Among persons without HIV infection, cryptococcosis is a growing concern both among immunocompromised and non-immunocompromised individuals. There are few detailed descriptions of these patients outside of North America and Western Europe.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>This prospective, observational, multinational study enrolled HIV-uninfected patients with proven\/probable cryptococcosis from 7 countries on 4 continents located in temperate, subtropical and tropical zones. Patients were identified based on culture, histopathology and\/or serologic testing. Relevant clinical and epidemiologic data were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 103 subjects with proven and probable cryptococcosis. Mean age was 53.8 years and 72% were male. Predisposing conditions were present in 70 patients (68%); most commonly malignancy, non-transplant related immunosuppressive therapy, and solid organ transplantation. Median time to diagnosis in non-immunocompromised individuals was 67 days compared to 19.7, 31.3 and 61 days for organ transplant, hematologic malignancy and other conditions, respectively. Survival at 3 and 12 months was similar across all risk groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Epidemiology, time to diagnosis, treatment and outcomes for HIV-uninfected persons with cryptococcosis in very diverse geographic regions are similar to data from North America and Western Europe.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag134","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T12:50:08Z","timestamp":1776430208000},"source":"Crossref","is-referenced-by-count":2,"title":["Epidemiology and Clinical Features of Cryptococcosis Among Individuals Without HIV Infection: An Observational International Multicenter Study (MSG-11)"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1816-9010","authenticated-orcid":false,"given":"Yee-Chun","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital and College of Medicine , Taipei ,","place":["Taiwan"]},{"name":"National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes , Zhunan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9983-6603","authenticated-orcid":false,"given":"Sharon C A","family":"Chen","sequence":"additional","affiliation":[{"name":"Center for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Westmead Hospital , Sydney, New South Wales ,","place":["Australia"]},{"name":"Faculty of Medicine and Heath, Sydney Medical School, The University of Sydney , New South Wales, Sydney ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald","family":"McGwin","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Alabama at Birmingham , Birmingham, Alabama ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1555-3807","authenticated-orcid":false,"given":"Arunaloke","family":"Chakrabarti","sequence":"additional","affiliation":[{"name":"Doodhadhari Burfani Hospital & Research Institute , Bhupatwala, Haridwar, Uttarakhand ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9599-3137","authenticated-orcid":false,"given":"Oliver A","family":"Cornely","sequence":"additional","affiliation":[{"name":"Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne, and Excellence Center for Medical Mycology (ECMM), Division of Infectious Diseases, Department I of Internal Medicine, Institute of Translational Research, University of Cologne , Cologne ,","place":["Germany"]},{"name":"German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne , Cologne ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0132-2277","authenticated-orcid":false,"given":"Aleksandra","family":"Barac","sequence":"additional","affiliation":[{"name":"Clinic for Infectious and Tropical Diseases, University Clinical Centre of Serbia , Belgrade ,","place":["Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4871-8113","authenticated-orcid":false,"given":"Harsimran","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research , Chandigarh ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivaprakash M","family":"Rudramurthy","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research , Chandigarh ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0336-1966","authenticated-orcid":false,"given":"Peter","family":"Phillips","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, St Paul's Hospital and the University of British Columbia , Vancouver, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7067-9141","authenticated-orcid":false,"given":"Carlos","family":"Seas","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, and Hospital Cayetano Heredia , Lima ,","place":["Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"McMullen","sequence":"additional","affiliation":[{"name":"Mycoses Study Group Central Unit, Department of Internal Medicine, Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3643-9931","authenticated-orcid":false,"given":"Peter G","family":"Pappas","sequence":"additional","affiliation":[{"name":"Mycoses Study Group Central Unit, Department of Internal Medicine, Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama 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Clinical manifestations of Cryptococcus gattii infection: determinants of neurological sequelae and death","volume":"55","author":"Chen","year":"2012","journal-title":"Clin Infect Dis"},{"key":"2026042214092903800_ofag134-B3","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1093\/cid\/ciab268","article-title":"MSG07: an international cohort study comparing epidemiology and outcomes of patients with Cryptococcus neoformans or Cryptococcus gattii infections","volume":"73","author":"Baddley","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2026042214092903800_ofag134-B4","doi-asserted-by":"crossref","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":"2026042214092903800_ofag134-B5","doi-asserted-by":"crossref","first-page":"e61921","DOI":"10.1371\/journal.pone.0061921","article-title":"Microbiological, epidemiological, and clinical characteristics and outcomes of patients with cryptococcosis in Taiwan, 1997\u20132010","volume":"8","author":"Tseng","year":"2013","journal-title":"PLoS One"},{"key":"2026042214092903800_ofag134-B6","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1186\/1471-2334-10-199","article-title":"A prospective descriptive study of cryptococcal meningitis in HIV uninfected patients in Vietnam\u2014high prevalence of Cryptococcus neoformans var. grubii in the absence of underlying disease","volume":"10","author":"Chau","year":"2010","journal-title":"BMC Infect Dis"},{"key":"2026042214092903800_ofag134-B7","doi-asserted-by":"crossref","first-page":"1748","DOI":"10.1016\/S1473-3099(22)00499-6","article-title":"The global burden of HIV-associated cryptococcal infection in adults in 2020: a modelling analysis","volume":"22","author":"Rajasingham","year":"2022","journal-title":"Lancet Infect Dis"},{"key":"2026042214092903800_ofag134-B8","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1093\/cid\/ciad321","article-title":"Current epidemiology and clinical features of Cryptococcus infection in patients without human immunodeficiency virus; a multicentre study of 46 hospitals in Australia and New Zealand","volume":"77","author":"Coussement","year":"2023","journal-title":"Clin Infect Dis"},{"key":"2026042214092903800_ofag134-B9","doi-asserted-by":"crossref","first-page":"myad125","DOI":"10.1093\/mmy\/myad125","article-title":"The incidences and clinical outcomes of cryptococcosis in Taiwan: a nationwide, population-based study, 2002\u20132015","volume":"62","author":"Guan","year":"2024","journal-title":"Med Mycol"},{"key":"2026042214092903800_ofag134-B10","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1086\/313992","article-title":"Epidemiology and host- and variety-dependent characteristics of infection due to Cryptococcus neoformans in Australia and New Zealand. 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