Browsing by Author "Stack, Matthew"

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    547. A Retrospective Cohort Study of Treatment Patterns and Clinical Outcomes in Patients with COVID-19
    (Oxford, 2020-10) Pritchard, Haley; Hiles, Jon; Teresa, Batteiger; Desai, Armisha; Wrin, Justin E; Hlavaty, Ariel; Agard, Amanda; Hinton, Bradley; Lucky, Christine W; Fleming, Elizabeth; Khan, Humaira; Bomkamp, John P; Derringer, Jon; Schneider, Jack; Ryder, Jonathan; Russ, Jason D; Khan, Haseeba; Kleyman, Svetlana; Enane, Leslie A; Stack, Matthew; Kussin, Michelle L; Myers, Courtney; Nagy, Allysa; Richardson, Noah; Elsheikh, Omar; Rahman, Omar; Kruer, Rachel; Trigonis, Russell; Butt, Saira; Bhumbra, Samina; Kapil, Sasha; Abi-Mansour, Tanya; Howe, Zachary; Abdallah, Wassim; Gupta, Samir; Wools-Kaloustian, Kara; Medicine, School of Medicine
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    Cryptococcal Meningitis in Young, Immunocompetent Patients: A Single-Center Retrospective Case Series and Review of the Literature
    (Oxford University Press, 2023-08-11) Stack, Matthew; Hiles, Jon; Valinetz, Ethan; Gupta, Samir K.; Butt, Saira; Schneider, Jack G.; Medicine, School of Medicine
    Background: Cryptococcal meningitis is an uncommon but serious infection with high mortality and morbidity. Classically described in immunocompromised patients, including those with solid organ transplants or HIV/AIDS, cryptococcosis has also been reported in young and otherwise healthy patients, albeit rarely. Methods: We retrospectively searched for all cases of cryptococcal meningitis in young (≤50 years) and previously healthy patients with no known immunocompromising conditions from January 2015 to January 2022 at Indiana University Health (IU Health). Additionally, a PubMed literature review was performed with the keywords "cryptococcal meningitis" and "immunocompetent" from January 1988 to January 2022. Clinical courses, including outcomes and treatment regimens, were evaluated. Results: We identified 4 local cases of cryptococcal meningitis in otherwise healthy patients age ≤50 years. Three cases were due to Cryptococcus neoformans, with 1 experiencing a postinfectious inflammatory response syndrome (PIIRS). The PubMed search identified 51 additional cases, with 32 (63%) being caused by Cryptococcus neoformans and 8 (17%) by Cryptococcus gattii. Of the 51 cases, only 2 resulted in death directly due to cryptococcosis. Fifteen (29%) had PIIRS, with steroid treatment documented in 11 of 15. Antifungal induction regimens and duration were varied but predominately consisted of amphotericin and flucytosine, with a mean induction duration of 5.0 weeks. Conclusions: Cryptococcal meningitis in young, previously healthy patients is likely under-recognized. PIIRS (akin to immune reconstitution inflammatory syndrome observed in HIV/AIDS) with prolonged recovery should be of concern. Determining risk factors for cryptococcosis in these patients remains elusive.