{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T06:20:44Z","timestamp":1773037244831,"version":"3.50.1"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cerebral cryptococcosis (neurocryptococcosis) is an important cause of meningoencephalitis among immunocompromised people worldwide, particularly in regions with limited access to antiretroviral therapy and to optimal antifungal agents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospective observational cohort study of consecutive adults hospitalized with cerebral cryptococcosis at the Neurology Service of the Servicio Aut\u00f3nomo Hospital Universitario de Maracaibo, Maracaibo, Zulia, Venezuela (January 2022 to July 2024). Data were collected using a validated instrument; modified Rankin Scale (mRS) assessed disability at discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty-two patients (mean age 36.5\u202f\u00b1\u202f12.9\u202fyears; 66.1% male) were included; 72.6% were HIV-positive. All patients presented headache, neck stiffness and altered mental status. Mean CSF protein was 103.5\u202fmg\/dL, cell count 504.5 cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      and glucose 33.8\u202fmg\/dL. Amphotericin B (daily regimen) was administered in 74.2% and fluconazole in 82.3%. Acute kidney injury (AKI) occurred in 59.7% and hypokalemia in 56.5%. In-hospital mortality was 46.8% (mRS 6). Mortality was higher in patients with AKI (35.5% vs. 11.3%;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.015) and hypokalemia (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.017). Mortality tended to be lower with daily versus alternate-day amphotericin (10% vs. 45%;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.297).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cerebral cryptococcosis in this referral setting affects predominantly young, HIV-infected adults and is associated with high mortality and disability. Amphotericin B-related nephrotoxicity and hypokalemia were common and associated with worse outcomes, underscoring the need for nephroprotection protocols and optimized antifungal strategies in resource-limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1776988","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T05:30:19Z","timestamp":1773034219000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["High mortality and amphotericin B-related nephrotoxicity in cerebral cryptococcosis in a low-resource neurology referral center: a prospective cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Johanne Yorshire","family":"Lobo Requena","sequence":"first","affiliation":[{"name":"Universidad del Zulia","place":["Maracaibo, Venezuela"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00e1ximo","family":"Quintero","sequence":"additional","affiliation":[{"name":"Universidad del Zulia","place":["Maracaibo, Venezuela"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Freddy","family":"Pachano Arenas","sequence":"additional","affiliation":[{"name":"Universidad del Zulia","place":["Maracaibo, Venezuela"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Belloso de Noriega","sequence":"additional","affiliation":[{"name":"Universidad del Zulia","place":["Maracaibo, Venezuela"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yadira","family":"Marin-Hamburger","sequence":"additional","affiliation":[{"name":"Universidad de la Costa","place":["Barranquilla, Colombia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sulaiman","family":"Kalokoh","sequence":"additional","affiliation":[{"name":"Faculty of Information and Communication Technology, Limkokwing University of Creative Technology","place":["Freetown, Sierra Leone"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabriccio J.","family":"Visconti-Lopez","sequence":"additional","affiliation":[{"name":"Universidad Cient\u00edfica Del Sur","place":["Lima, Peru"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1038\/nrmicro.2015.6","article-title":"Cryptococcus: from environmental saprophyte to global pathogen","volume":"14","author":"May","year":"2016","journal-title":"Nat Rev Microbiol"},{"key":"ref2","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 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