{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:04:33Z","timestamp":1790136273045,"version":"4.0.1"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:00:00Z","timestamp":1664150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2021YFC2300400"],"award-info":[{"award-number":["2021YFC2300400"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81971911"],"award-info":[{"award-number":["81971911"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cryptococcal meningitis (CM) is increasingly recognised in human immunodeficiency virus (HIV)\u2010uninfected patients with high mortality. The efficacy and safety profiles of induction therapy with high\u2010dose fluconazole plus flucytosine remain unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>HIV\u2010uninfected CM patients who received high\u2010dose fluconazole (800\u2009mg\/d) for initial therapy in Huashan Hospital were included in this retrospective study from January 2013 to December 2018. Efficacy and safety of initial therapy, clinical outcomes and risk factors were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010seven (71.1%) patients who received high\u2010dose fluconazole with flucytosine combination therapy and 11 (28.9%) having fluconazole alone for induction therapy were included. With a median duration of 42\u2009days (IQR, 28\u201386), the successful response rate of initial therapy was 76.3% (29\/38), while adverse drug reactions occurred in 14 patients (36.8%). The rate of persistently positive cerebrospinal fluid (CSF) culture results was 30.6% at 2\u2009weeks, which was significantly associated with CSF CrAg titre &gt;1:1280 (OR 9.56; 95% CI 1.40\u2013103.65; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.010) and CSF culture of <jats:italic>Cryptococcus<\/jats:italic>\u2009&gt;3.9 log<jats:sub>10<\/jats:sub>CFU\/ml (OR 19.20; 95% CI 1.60\u2013920.54; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.011), and decreased to 8.6% at 4\u2009weeks. One\u2010year mortality was 15.8% (6\/38), and low serum albumin (35\u2009g\/L) was found as an independent risk factor for 1\u2010year mortality (HR 6.31; 95% CI 1.150\u201334.632; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.034).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Induction therapy with high\u2010dose fluconazole (800\u2009mg\/d), combined with flucytosine, effectively treated HIV\u2010uninfected CM and was well tolerated. Long\u2010term fluconazole treatment with continued monitoring is beneficial for patients with persistent infection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13528","type":"journal-article","created":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T06:43:56Z","timestamp":1663310636000},"page":"59-68","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Induction therapy with high\u2010dose fluconazole plus flucytosine for human immunodeficiency virus\u2010uninfected cryptococcal meningitis patients: Feasible or not?"],"prefix":"10.1111","volume":"66","author":[{"given":"Hua\u2010Zhen","family":"Zhao","sequence":"first","affiliation":[{"name":"Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Department of Infectious Diseases Huashan Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia\u2010Hui","family":"Cheng","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Department of Infectious Diseases Huashan Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling\u2010Hong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Department of Infectious Diseases Huashan Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Luo","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Department of Infectious Diseases Huashan Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong\u2010Sheng","family":"Zhu","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Department of Infectious Diseases Huashan Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying\u2010Kui","family":"Jiang","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Department of Infectious Diseases Huashan Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Department of Infectious Diseases Huashan Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3098-7307","authenticated-orcid":false,"given":"Li\u2010Ping","family":"Zhu","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Department of Infectious Diseases Huashan Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2016.167"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz193"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30243-8"},{"issue":"7","key":"e_1_2_9_5_1","first-page":"ofab296","article-title":"Clinical predictors impacting cryptococcal dissemination and poor outcome in patients with cirrhosis. 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