Risk for a poor outcome:
(1) cerebral infarcts
(2) Glasgow outcome score <= 3
(3) CSF glucose concentration < 30 mg/dL
(4) delayed diagnosis (because cryptococcosis is often not considered in an immunocompetent host)
|
Outcome
|
Glasgow Outcome Score
|
|
death
|
1
|
|
vegetative state
|
2
|
|
severe disability
|
3
|
|
moderate disability
|
4
|
|
no or mild disability (good outcome)
|
5
|
The diagnosis of CNS cryptococcosis should be considered in a patient with a chronic headache and one or more of the following:
(1) fever
(2) weakness
(3) anorexia
(4) neurologic complaints (hearing loss, hemiplegia, cranial nerve palsy, ataxia, dysarthria)
(5) ophthalmologic complaints (diplopia, blurred vision, photophobia, blindness)
(6) lethargy
(7) abnormal neuroradiologic findings (leptomeningeal enhancement, cerebral infarcts, diffuse brain edema, cystic lesions, other)
