Malignancy in non-HIV infected patients with cryptococcal meningitis: a retrospective study

Abstract Background : Cryptococcal meningitis (CM) was found to be coexist with malignancy in non-human immunodeficiency virus (HIV) infected patients. The purpose of this study was to evaluate the clinical characteristics and therapeutic outcomes of CM in non-HIV infected patients with malignancy. Methods : A total of 320 CM patients were enrolled for analysis from January 2013-May 2019. One hundred and four patients underwent positron emission computed tomography (PET-CT) examination. The demographics, clinical characteristics, microbiological, radiological, therapeutic outcomes were analyzed in CM patients with and without malignancy. Results : Twelve patients with malignancy were found, of which 7 malignancy before CM (MBC), 5 malignancy after CM (MAC). CM patients with malignancy were older than non-malignancy ones. The prognosis of MBC patients was comparable to that of non-malignancy patients, but was extremely poor in MAC patients. Four out of 5 CM patients, who was suggested diagnosis as malignancy by PET-CT, were finally confirmed. Conclusions : This study found an increase rate of solid malignancies in CM patients. Screening malignancy in older CM patients was very important because it is closely related to prognosis and might affect treatment strategy. PET-CT might be a useful tool for early malignancy screening in CM.