{"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":1784248952474,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T00:00:00Z","timestamp":1653436800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR002377"],"award-info":[{"award-number":["UL1TR002377"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>Cryptococcus<\/jats:italic> spp. infection involving the central nervous system (CNS) is associated with poor outcomes. Current guidelines recommend repeating a cerebrospinal fluid (CSF) fungal culture after 2\u2009weeks of treatment to evaluate for clearance. However, this practice has not clearly been associated with outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We sought to assess the relationship between CSF fungal clearance at 2\u2009weeks and 12\u2010month mortality in patients with CNS cryptococcosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective cohort study from 2011 to 2020 of patients with CNS cryptococcosis. Factors associated with 12\u2010month mortality were assessed with Fisher\u2019s exact test for categorical variables and Mann\u2013Whitney test for continuous variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 51 patients with CNS cryptococcosis, 42 (82.4%) were initially CSF culture positive. Among 27 patients with follow\u2010up CSF culture at 2\u2009weeks, 6 (22.2%) had a positive result. Factors associated with a positive CSF culture at 2\u2009weeks were an initial CSF cryptococcal antigen titre \u22651:2560, fungaemia, and an elevated intracranial pressure requiring therapeutic lumbar punctures. The 12\u2010month mortality rate was 33.3%, and this was significantly associated with baseline fungaemia, extra\u2010CNS cryptococcal involvement and requirement of intensive care unit level of care. Lack of CSF culture clearance by 2\u2009weeks was not associated with 12\u2010month mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CNS cryptococcosis has a high mortality rate. A markedly elevated CSF cryptococcal antigen, and opening CSF pressure was associated with lack of CSF culture clearance at 2\u2009weeks of treatment. Severe disseminated disease and cryptococcemia were associated with 12\u2010month mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13467","type":"journal-article","created":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T09:57:32Z","timestamp":1652176652000},"page":"733-740","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical and microbiologic outcomes of central nervous system cryptococcosis: Re\u2010examining the need for a 2\u2010week cerebrospinal fluid analysis"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2098-2868","authenticated-orcid":false,"given":"Zachary A.","family":"Yetmar","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nischal","family":"Ranganath","sequence":"additional","affiliation":[{"name":"Division of Infectious 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